In subjects with normal myocardial relaxation,
E and e´ velocities increase proportionally (Table 2), and
the E/e´ ratio remains unchanged or is reduced.145
However, in patients with impaired myocardial relaxation,
the increase in e´ with exercise is much less than that of mitral E velocity, such that the E/e´ ratio increases.146 In
that regard, E/e´ was shown to relate significantly to LV
filling pressures during exercise, when Doppler echocardiography
was acquired simultaneously with cardiac catheterization.
147 In addition, mitral DT decreases slightly in normal
individuals with exercise, but shortens .50 ms in patients
with a marked elevation of filling pressures.