The time interval between the onset of tricuspid E wave and annular Ea wave (TE-Ea) can predict right atrial pressure in patients with heart failure.

Objective: There is conflicting data regarding the tricuspid annular velocities and their relation to right ventricular filling pressures. We aimed to assess if the time interval between the onset of tricuspid E wave and annular Ea wave has any correlation with right sided filling pressure in patients with heart failure.
Methods: Thirty heart failure patients (left ventricular ejection fraction≤35%) were enrolled. Echocardiography was performed to obtain tricuspid inflow and tissue Doppler annular velocities just before a standard right heart catheterization. The right atrial pressure was obtained from right heart catheterization. The E/Ea [the ratio of peak velocity of early tricuspid inflow wave (E) to peak velocity of early diastolic wave of the lateral tricuspid annulus (Ea)] and the time intervals between the beginning of R wave of electrocardiogram and onset of E (TE) as well as between the beginning of R wave and onset of Et (TEa) were measured, TE-Ea was calculated as TE-TEa.
Results: The mean right atrial pressure (RAP) was 8.8 (SD=4.7) mm Hg. The mean TE-Ea was + 8.61 milliseconds. There was no significant correlation between RAP and E/Ea (r=0.08, p>0.05) but the correlation between TE-Ea and RAP was significant (r=0.5, p=0.01).
Conclusion: According to our results and in contrary to some prior studies, we showed for the first time that right side TE-Ea stands as a better surrogate of right atrial pressure than E/Ea in heart failure patients. This finding needs more accurate studies and could present TE-Ea as a feasible tool to look into hemodynamics of heart failure patients.