Evidence mapPaperPMID 11997279Full record

ArticleCirculation2002

Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the Strong Heart Study.

Jonathan N Bella, Vittorio Palmieri, Mary J Roman, Jennifer E Liu, Thomas K Welty, Elisa T Lee, Richard R Fabsitz, Barbara V Howard, Richard B Devereux

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Circulation, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01761318 (Magnetic Resonance Assessment of Victoza Efficacy in the Regression of Cardiovascular Dysfunction In Type 2 Diabetes Mellitus), which is not on this map. Cited by 120 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 2 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01761318 phase4completedstarted 2013, after this paper: background citation

Magnetic Resonance Assessment of Victoza Efficacy in the Regression of Cardiovascular Dysfunction In Type 2 Diabetes Mellitus

Ran2013Enrolled50Registered outcomes48Posted comparisons0ConditionsCardiovascular Disease, Diabetes Mellitus Type 2, Diastolic Dysfunction, Fatty LiverArmsliraglutide, Liraglutide - Placebo
Open the trial in the graph
3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  8. Association of Impaired Relaxation Mitral Inflow Pattern (Grade 1 Diastolic Function) With Long-Term Noncardiovascular and Cardiovascular Mortality.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2025
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  16. Myocardial contraction fraction predicts mortality in the oldest old.International journal of cardiology. Heart & vasculature · 2022
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  19. Can echocardiographic assessment of diastolic function be automated?The international journal of cardiovascular imaging · 2022
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  20. Article

60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonathan N BellaWeill Medical College of Cornell University, New York, NY, USA. jonnbella@earthlink.net
Vittorio Palmieri
Mary J Roman
Jennifer E Liu
Thomas K Welty
Elisa T Lee
Richard R Fabsitz
Barbara V Howard
Richard B Devereux

Funding

VEGF VECTOR TO ISCHEMIC MYOCARDIUM W/DIFFUSE CORONARY DISEASEM01RR000047 · WEILL MEDICAL COLLEGE OF CORNELL UNIV · 1985 to 2005
$29.1M
CARDIOVASCULAR DISEASE IN THE PIMA INDIANSU01HL041642 · MEDSTAR RESEARCH INSTITUTE · 1988 to 2005
$6.8M
CARDIOVASCULAR DISEASE IN SIOUX INDIANSU01HL041652 · U.S. PHS INDIAN HEALTH SERVICE · 1988 to 2005
$4.2M
NCRR NIH HHS M10-RR0047-34NHLBI NIH HHS HL-41642NHLBI NIH HHS HL-41652NHLBI NIH HHS HL-41654
6 · The paper itself

Abstract

backgroundWith aging, left ventricular filling tends to decrease in early diastole, reducing the mitral ratio of peak early to late diastolic filling velocity (E/A). However, the prognostic significance of low or high E/A in older adults remains to be elucidated in population-based samples. METHODS AND

resultsDoppler echocardiograms were analyzed in 3008 American Indian participants in the second Strong Heart Study examination who had no more than mild mitral or aortic regurgitation. Participants were followed for a mean of 3 years after Doppler echocardiography to assess risks of all-cause and cardiac death associated with E/A <0.6 or >1.5; 2429 (81%) participants had normal E/A ratio, 490 (16%) had E/A <0.6, and 89 (3%) had E/A >1.5. All-cause mortality was higher with E/A <0.6 or E/A >1.5 (12% and 13% versus 6%), as was cardiac mortality (4.5% and 6.5% versus 1.6%; both P<0.001). Adjusting for age, sex, body mass index, systolic blood pressure, HDL and LDL cholesterol, smoking, hypertension, diabetes, coronary heart disease, left ventricular hypertrophy, and low ejection fraction (<40%), the relative risk of all-cause death with E/A >1.5 was 1.73 (95% CI, 0.99 to 3.03; P=0.05); the relative risk of cardiac death was 2.8 (95% CI, 1.19 to 6.75; P<0.05). E/A <0.6 was not independently associated with increased all-cause or cardiac mortality (P=0.19 and 0.31, respectively) after adjusting for covariates.

conclusionsIn a population-based sample of middle-aged and elderly adults, mitral E/A >1.5 at baseline Doppler echocardiography is associated with 2-fold increased all-cause and 3-fold increased cardiac mortality independent of covariates; mitral E/A <0.6 was also associated with 2-fold increased all-cause and cardiac mortality but not independent of covariates.

Indexed as

Mitral ValveVentricular Function, LeftAgedAgingBlood Flow VelocityCohort StudiesDeath, Sudden, CardiacDiastoleEchocardiography, DopplerFemaleHeart VentriclesHumansMaleMiddle AgedMyocardial InfarctionPrognosis

Identifiers

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.