Okura H, Takada Y, Kubo T, Iwata K, Mizoguchi S, Taguchi H, Toda I, Yoshikawa J, Yoshida K
Division of Cardiology, Bell Land General Hospital, Sakai, Japan.
Heart. 2006 Sep;92(9):1248-52. doi: 10.1136/hrt.2005.082594. Epub 2006 Jan 31.
To investigate whether the ratio of early transmitral flow velocity (E) to early diastolic mitral annular velocity (E') predict prognosis in patients with non-valvular atrial fibrillation.
230 patients with non-valvular atrial fibrillation were enrolled and studied. According to E/E' value, patients were divided into groups with lower (group A with E/E' <or= 15) and higher (group B with E/E' > 15) E/E'.
During follow up (average 245 days), 21 (9.1%) deaths were documented. All cause death (15/90 (16.7%) v 6/140 (4.3%)), cardiac death (10 (11.1%) v 2 (1.4%)) and congestive heart failure (16 (17.8%) v 8 (5.7%)) were more common in group B than in group A (all p < 0.01). A Kaplan-Meier survival curve showed that the cumulative survival rate was significantly lower in group B than in group A (log rank p = 0.0013). By multivariate logistic regression analysis, E/E' (chi(2) = 4.47, odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01 to 1.11, p = 0.03) and age (chi(2) = 6.45, OR 1.06, 95% CI 1.01 to 1.11, p = 0.02) were independent predictors of mortality.
The Doppler-derived index of left ventricular filling pressure, E/E', is a powerful predictor of the clinical outcome of patients with non-valvular atrial fibrillation.
探讨早期二尖瓣血流速度（E）与舒张早期二尖瓣环速度（E'）的比值是否可预测非瓣膜性心房颤动患者的预后。
纳入并研究230例非瓣膜性心房颤动患者。根据E/E'值，将患者分为E/E'较低组（A组，E/E'≤15）和较高组（B组，E/E'>15）。
在随访期间（平均245天），记录到21例（9.1%）死亡。全因死亡（15/90（16.7%）对6/140（4.3%））、心源性死亡（10例（11.1%）对2例（1.4%））和充血性心力衰竭（16例（17.8%）对8例（5.7%））在B组比A组更常见（均p<0.01）。Kaplan-Meier生存曲线显示，B组的累积生存率显著低于A组（对数秩检验p=0.0013）。通过多因素逻辑回归分析，E/E'（χ²=4.47，比值比（OR）1.05，95%置信区间（CI）1.01至1.11，p=0.03）和年龄（χ²=6.45，OR 1.06，95%CI 1.01至1.11，p=0.02）是死亡率的独立预测因素。
多普勒衍生的左心室充盈压指标E/E'是预测非瓣膜性心房颤动患者临床结局的有力指标。
