BACKGROUND: The ratio of mitral end-diastolic velocity and mitral annular early diastolic motion velocity (E/e') has predictive value in patients with acute coronary syndromes (ACS). Both E and e' velocities change with age. The prognostic value of E/e' in elderly patients with ACS has not been established yet. The aim of the study was to assess the prognostic significance of E/e' in patients over 65 with ACS. METHOD: The study involved 168 patients, mean age 79 years. Echocardiography was performed within first 24 hours of ACS. Clinical evaluation, 6-minute walk test, echocardiography and plasma level of NT pro-BNP were performed 12 months later. RESULTS: Patients, who were still alive after 1-year follow-up had significantly lower E/e' during hospitalization: 11.1 ± 3 versus 15.1 ± 5 (P < 0.05). The optimal cutoff value of E/e' differentiating survivors and nonsurvivors after 12 month follow-up was 12. Initial E/e' was an independent predictor of mortality during 1-year follow-up. E/e' ratio during hospitalization significantly correlated with NT pro-BNP concentration (r = 0.48, P < 0.001) and 6-minute walking distance: (r =-0.32, P < 0.05) after 1-year follow-up. CONCLUSIONS: (1) In patients over 65 with myocardial infarction, E/e' above 12 is an independent predictor of death during 1-year follow-up. (2) E/e' ratio in acute phase of myocardial infarction correlated significantly with N pro-BNP level and 6-minute walking distance after 1-year follow-up.
BACKGROUND: The ratio of mitral end-diastolic velocity and mitral annular early diastolic motion velocity (E/e') has predictive value in patients with acute coronary syndromes (ACS). Both E and e' velocities change with age. The prognostic value of E/e' in elderly patients with ACS has not been established yet. The aim of the study was to assess the prognostic significance of E/e' in patients over 65 with ACS. METHOD: The study involved 168 patients, mean age 79 years. Echocardiography was performed within first 24 hours of ACS. Clinical evaluation, 6-minute walk test, echocardiography and plasma level of NT pro-BNP were performed 12 months later. RESULTS:Patients, who were still alive after 1-year follow-up had significantly lower E/e' during hospitalization: 11.1 ± 3 versus 15.1 ± 5 (P < 0.05). The optimal cutoff value of E/e' differentiating survivors and nonsurvivors after 12 month follow-up was 12. Initial E/e' was an independent predictor of mortality during 1-year follow-up. E/e' ratio during hospitalization significantly correlated with NT pro-BNP concentration (r = 0.48, P < 0.001) and 6-minute walking distance: (r =-0.32, P < 0.05) after 1-year follow-up. CONCLUSIONS: (1) In patients over 65 with myocardial infarction, E/e' above 12 is an independent predictor of death during 1-year follow-up. (2) E/e' ratio in acute phase of myocardial infarction correlated significantly with N pro-BNP level and 6-minute walking distance after 1-year follow-up.