Salemi et al used echocardiography to evaluate patients with biventricular endomyocardial fibrosis (EMF). The average peak velocities of the late diastolic mitral annular velocities predicts oxygen consumption, which correlates with outcome. The authors are from the University of Sao Paulo, Massachusetts General Hospital and Harvard Medical School.


Patient selection: biventricular EMF


Analysis: peak A’ (late diastolic mitral annular velocity) at 4 sites (anterior, lateral, inferior, septum), in cm/s


average peak A’ =

= SUM(peak A’ at the 4 sites in cm/s) / 4


According to the text (Figure 2, page 404):


percent of predicted VO2 =

= (322.44 * (average peak A’)) + 26.34


This cannot work using the data in the paper.


If the data in Figure 2 is analyzed, the equation should be:


percent of predicted VO2 =

= (2.71 * (average peak A’)) + 30.76



• The original equation may require the slope and intercept to be reversed and divided by 10.


Mortality was associated with the percent of predicted VO2. When it was < 53% the mortality was worse. This corresponds to an average peak A’ of 8.2.


According to Figure 3 (page 404) the survival for a predicted VO2 >= 53% was 95% for 70 months (then everyone abruptly died). The median survival if the predicted VO2 < 53% was 20 months, then stabilized at 45 percent (then everyone abruptly died at 67 months).


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