What does an abnormal result of 14.2 indicate?

Interpreting an Abnormal Value of 14.2

An abnormal value of 14.2 most likely indicates an elevated E/e' ratio, which suggests increased left ventricular filling pressures and diastolic dysfunction. 1

Significance of E/e' Ratio of 14.2

• An E/e' ratio >14 is considered abnormal and indicates elevated left atrial pressure (LAP) and diastolic dysfunction 1
• This value exceeds the cutoff of 14 established by the American Society of Echocardiography and European Association of Cardiovascular Imaging for identifying abnormal diastolic function 1
• An E/e' ratio of 14.2 is consistent with at least Grade II diastolic dysfunction (pseudonormal filling pattern) 1

Clinical Implications

• Elevated E/e' ratio is associated with increased risk of heart failure, particularly heart failure with preserved ejection fraction (HFpEF) 1
• This finding suggests impaired left ventricular relaxation with elevated filling pressures 1
• The abnormal value indicates higher risk for cardiovascular morbidity and mortality 1

Confirmation and Additional Assessment

• This finding should be interpreted in context with other echocardiographic parameters to confirm diastolic dysfunction 1:

  • Left atrial volume index (abnormal if >34 mL/m²) 1
  • Peak tricuspid regurgitation velocity (abnormal if >2.8 m/sec) 1
  • Mitral inflow patterns (E/A ratio) 1

• If E/A ratio is between 0.8 and 2.0, the elevated E/e' ratio of 14.2 confirms Grade II diastolic dysfunction 1

• If E/A ratio is ≥2.0, this would suggest Grade III (restrictive) diastolic dysfunction 1

Management Considerations

• Treatment should focus on underlying causes such as hypertension, coronary artery disease, or other contributing factors 2
• Blood pressure control with ACE inhibitors or ARBs may improve ventricular relaxation 2
• Beta-blockers may be beneficial to increase diastolic filling time, particularly with concomitant coronary artery disease 2
• Regular follow-up echocardiography is recommended to monitor for progression 2

Common Pitfalls to Avoid

• Failure to interpret E/e' ratio in context with other parameters can lead to misdiagnosis 1
• Technical factors can affect measurements, including improper tissue Doppler sample volume placement 1
• E/e' ratio may be less reliable in certain conditions such as mitral valve disease, left bundle branch block, or paced rhythm 1
• Isolated interpretation of E/e' without clinical correlation may lead to overdiagnosis of diastolic dysfunction 1