High e/a ratio?

[BAV]

Hi everyone,

I have a bicuspid aortic valve with moderate or moderate stenosis with regurgitation that just passed into severe and looking to have aortic valve replacement in 6 weeks via Ross procedure.

I'm concerned because my most recent echo shows e/a ratio of 2.6 which charts indicate is grade iii diastolic dysfunction when combined with three of the below mentioned criteria ( I only have 1) Can you grade the diastolic dysfunction by e/a on its own?

1My e/e is 12 which is in range (under 14) - pass

2. septal e is 7 and lateral is 10 which is in range but on the cusp ( anything lower is a fail) - barely pass

3. Left atrium size is a little over the limit at 38 instead of 34 limit. - barely fail

I 4. have no peak tricuspid regurgitation. Anything over 2.8 m/s2 is a fail - pass

According to many chart flows if you only have one the above 4 mentioned criteria you don't have diastolic dysfunction. If you have 2 then it's indeterminate and 3 orn4 is positive indication. Once it's determined you have diastolic dysfunction it is the based off of the e/a ratio and anything over 2.5 is grade iii which seems bad.

Also, is it matters my echo a year ago showed similar numbers with a higher e/a ratio around 2 and e/e around 11 and 36 left atrial size. But then the next exho six months later in November showed normal LA size, much lower e/a at 1.06 and e/e much lower at 6. It's weird it went up and down so much but my surgeon says that that the pressure from my aortic valve makes the mitral valve readings wonky and it should sort itself out . He is a world class surgeon by the way and top of his field.

Edit: I pulled even older echos and one from 2020 has the e/a at 2.01 then it went down to 1.08 in 2021. It's weird how this value changes so much and supposedly gives an idea as of the pressure in diastole between beats. I did come across literature mentioning younger people who are athletes could have ratios 2.5 or higher and it's fine for them . I'm not particularly young at almost 37 but i do workout very regularly consistently for the last 4 years.

I asked my surgeon about it and he said not to worry that my hearts a little stiff from the extra work but it should get better after surgery.he also said the pressure from my aortic valve makes the readings on the Mitral valve wonky. . I really hope this is the case because I'm definitely fatigued and not wanting to do much more than the required minimum even though I'm still exercising 3 or 4 times a week..

Can anyone shed any light if I should be worried about permanent damage ? Has anyone had a higher e/a ratio prior to surgery get better afterwords? I'm really hoping to feel better after my procedure. I'm only 36 with a family to support

 

[Survived03]

I asked my surgeon about it and he said not to worry that my hearts a little stiff from the extra work but it should get better after surgery.he also said the pressure from my aortic valve makes the readings on the Mitral valve wonky.

In my opinion, your surgeon's response is what you might want to focus on. It's amazing how the heart can remodel after surgery. What does your cardiologist say?

Good luck!

 

[BAV]

In my opinion, your surgeon's response is what you might want to focus on. It's amazing how the heart can remodel after surgery. What does your cardiologist say?

Good luck!

Hi survived,

Thanks for the response. I'm going to try and not freak out too much over it lol. I tend to obsess over medical stuff sometimes.

My cardiologist is supposed to call me Tuesday via our correspondence on our health portal . He never mentioned any of these values. I came across them by googling myself haha. This is why they tell you not to google health stuff!

 

[pellicle]

Hi

He never mentioned any of these values. I came across them by googling myself haha. This is why they tell you not to google health stuff!

for myself I don't really understand these things, some others here do. I (despite being in and around this most of my life) have chosen to abdicate this control to my surgeon / cardiologist and focus on the things which I'm personally responsible for:

• frame of mind (positive outlook)
• good diet
• moderate sensible regular daily exersize
• understanding how to manage my ACT

Best Wishes

 

[pellicle]

Oh ... on this

This is why they tell you not to google health stuff!

there is a LOT of background knowledge needed to even begin reading journal articles and they can not be read quickly.

Worse, Google seldom points you to peer reviewed journals because its an advertising company not an education public service. So they will steer you like a shepherd if you let them; perhaps worse, they'll steer you to your own slaughter if that pays more.

Sabine says it well here:


tangentially related content here:


Ryan makes good points on how easy it is for Farcebook or Twix or whatever to fix the problem ... but they don't.

 

[BAV]

Oh ... on this

there is a LOT of background knowledge needed to even begin reading journal articles and they can not be read quickly.

Worse, Google seldom points you to peer reviewed journals because its an advertising company not an education public service. So they will steer you like a shepherd if you let them; perhaps worse, they'll steer you to your own slaughter if that pays more.

Sabine says it well here:


tangentially related content here:


Ryan makes good points on how easy it is for Farcebook or Twix or whatever to fix the problem ... but they don't.

Thanks Pellicle. I'll try to keep this in mind when I'm trying to research complex medical info. It's easy to work yourself up

 

[pellicle]

It's easy to work yourself up

Best strategy as I see it is don't research for its own sake. Don't seek answers to broad general questions.

Seek opinions of your findings here as a large diversity of knowledge exists here.

Best wishes