What does a high E/e' ratio suggest in echocardiographic assessments?

The E/e' ratio is a valuable echocardiographic measure used to assess diastolic function and indirectly estimate left ventricular filling pressures. When this ratio is elevated, it typically indicates that there is an increase in left ventricular filling pressures. This situation often arises in conditions like heart failure or diastolic dysfunction, where the compliance of the left ventricle is reduced, leading to higher pressures being required to fill the heart adequately.

In clinical practice, a high E/e' ratio can be indicative of increased pressure in the left atrium and can suggest that the heart is struggling to fill during diastole. This measurement is particularly useful for assessing patients with suspected heart failure, as it helps differentiate between types of heart failure and guides treatment decisions. Therefore, the interpretation of a high E/e' ratio as indicating elevated left ventricular filling pressures is well-supported by echocardiographic evidence and clinical associations.