Sharma Rajan, Pellerin Denis, Gaze David C, Mehta Rajnikant L, Gregson Helen, Streather Christopher P, Collinson Paul O, Brecker Stephen J D
Department of Cardiology, Chemical Pathology, St George's Hospital, London, United Kingdom.
J Am Soc Echocardiogr. 2006 Mar;19(3):266-73. doi: 10.1016/j.echo.2005.10.006.
The study aimed to assess whether the mitral peak Doppler E-wave to peak mitral annulus velocity ratio (E/Ea) estimates left ventricular (LV) filling pressure (LVFP) and predicts mortality in end-stage renal disease.
In all, 125 candidates for renal transplant were prospectively studied. LV end-diastolic pressure of 15 mm Hg or greater at cardiac catheterization was defined as elevated LVFP.
Severe coronary artery disease, N- terminal pro-B-type natriuretic peptide level, left atrial size, flow propagation velocity, mitral E/Ea ratio, pulmonary atrial reversal velocity, and pulmonary-mitral atrial wave duration predicted an increased LVFP. However, the mitral E/Ea ratio (odds ratio 8.1, 95% confidence interval 5.1-9.6, P = .003) was the only independent predictor. An E/Ea of 15 or more, seen in 31 (25%) patients, predicted increased LVFP with sensitivity of 82% and specificity of 88%, and was associated with increased mortality (P = .005).
In end-stage renal disease, mitral E/Ea ratio 15 or higher accurately predicts increased LVFP and mortality.
本研究旨在评估二尖瓣峰值多普勒E波与二尖瓣环峰值速度比值（E/Ea）是否可用于估计终末期肾病患者的左心室充盈压（LVFP）并预测其死亡率。
前瞻性研究了125例肾移植候选者。心脏导管检查时左心室舒张末期压力≥15 mmHg被定义为LVFP升高。
严重冠状动脉疾病、N末端B型利钠肽原水平、左心房大小、血流传播速度、二尖瓣E/Ea比值、肺静脉心房逆向速度以及肺静脉-二尖瓣心房波持续时间均可预测LVFP升高。然而，二尖瓣E/Ea比值（优势比8.1，95%置信区间5.1 - 9.6，P = 0.003）是唯一的独立预测因子。31例（25%）患者的E/Ea≥15，其预测LVFP升高的敏感性为82%，特异性为88%，且与死亡率增加相关（P = 0.005）。
在终末期肾病中，二尖瓣E/Ea比值≥15可准确预测LVFP升高及死亡率增加。
