Wallentin Guron Cecilia, Bech-Hanssen Odd, Wikh Ronny, Rosengren Annika, Hartford Marianne, Caidahl Kenneth
Department of Clinical Physiology, Sahlgrenska University Hospital, SE 416 85 Göteborg, Sweden.
Eur J Echocardiogr. 2005 Dec;6(6):419-28. doi: 10.1016/j.euje.2005.01.005. Epub 2005 Mar 31.
A ratio>15 between the early diastolic pulsed Doppler velocities of the mitral inflow (E) and the basal left ventricular (LV) tissue (e) has been demonstrated to predict an elevated LV filling pressure (FP). An elevated LVFP implies an elevated right ventricular pressure (RVp). In order to investigate the sensitivity of the E/e filling index, we compared E/e and RVp, in their ability to identify a Doppler-assumed elevation of LVFP.
Application of pulsed Doppler international recommendations grouped 134 patients with acute coronary syndromes (ACS) and 50 age- and sex-matched controls, according to LV filling: normal; delayed relaxation; an isolated pathological mitral-pulmonary venous-A-wave-duration difference; pseudo normal; or a restrictive filling pattern. An E/e>15 and an RVp>30 mmHg showed the following (%) sensitivity (32/94), specificity (95/76), positive (68/59), and negative (80/97) predictive values of a Doppler-assumed elevation of LVFP, in terms of either a pseudo normal or a restrictive filling pattern.
The low sensitivity of E/e to detect a Doppler-assumed elevation of LVFP could limit its clinical usefulness as a single variable, in ACS. The high sensitivity and negative predictive value of RVp support its use as an additional LV filling variable in these patients.
二尖瓣流入道舒张早期脉冲多普勒速度（E）与左心室基底组织速度（e）之比>15已被证明可预测左心室充盈压（FP）升高。左心室充盈压升高意味着右心室压力（RVp）升高。为了研究E/e充盈指数的敏感性，我们比较了E/e和RVp识别多普勒假定的左心室充盈压升高的能力。
应用脉冲多普勒国际推荐标准，根据左心室充盈情况将134例急性冠状动脉综合征（ACS）患者和50例年龄及性别匹配的对照者分为：正常；舒张延迟；孤立的病理性二尖瓣-肺静脉A波持续时间差异；假性正常；或限制性充盈模式。E/e>15且RVp>30 mmHg在识别多普勒假定的左心室充盈压升高方面，对于假性正常或限制性充盈模式，显示出以下（%）敏感性（32/94）、特异性（95/76）、阳性（68/59）和阴性（80/97）预测值。
E/e检测多普勒假定的左心室充盈压升高的敏感性较低，这可能会限制其在急性冠状动脉综合征中作为单一变量的临床应用价值。右心室压力的高敏感性和阴性预测值支持将其作为这些患者左心室充盈的一个附加变量。
