Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Circ J. 2011;75(10):2350-6. doi: 10.1253/circj.cj-11-0015. Epub 2011 Jul 28.
The purpose of this study was to investigate the prognostic values of the E/e' ratio and other echocardiographic and clinical parameters in patients with non-valvular atrial fibrillation (AF) with preserved left ventricular (LV) systolic function.
A total of 488 patients (322 men, age: 66 ± 11 years) with non-valvular AF with preserved LV systolic function (LV ejection fraction >50%) were included. The E and e' velocities were measured in 5 consecutive heart beats and averaged. Mean follow-up duration after enrollment was 17.7 ± 5.3 months. All-cause deaths occurred in 45 patients (cardiovascular deaths: n=29). There were significant differences in age (65.6 ± 11.3 vs. 71.5 ± 9.1, P < 0.001) and hemoglobin concentration (13.6 ± 2.9 vs. 11.5 ± 3.4g/dl, P<0.0001) between the deceased group and the survivors. E/e' ratio in the deceased group was significantly higher than that in the survivors (17.67 ± 3.39 vs. 10.8 ± 3.30, P < 0.001). Survival analysis showed that a high E/e' ratio (> 15.0) represents a poorer prognosis (P < 0.001 by Log-Rank test) than an E/e' ratio of 15 and below. Multivariate analysis identified 2 significant variables that were predictive of all-cause deaths: hemoglobin (hazard ratio (HR)=0.806, 95% confidence interval (CI) = 0.733-0.886, P < 0.0001), and E/e' > 15 (HR=3.064, 95%CI = 1.38-6.804, P = 0.006).
E/e' ratio is a useful independent prognostic parameter for predicting mortality in patients with AF with preserved LV systolic function.
本研究旨在探讨 E/e' 比值及其他超声心动图和临床参数在左心室射血分数保留的非瓣膜性心房颤动（AF）患者中的预后价值。
共纳入 488 名（男 322 名，年龄：66±11 岁）非瓣膜性 AF 且左心室射血分数保留（LV 射血分数>50%）的患者。在 5 个连续心跳中测量 E 和 e'速度并取平均值。入组后平均随访时间为 17.7±5.3 个月。45 例患者（心血管死亡：n=29）发生全因死亡。死亡组与存活组在年龄（65.6±11.3 与 71.5±9.1，P<0.001）和血红蛋白浓度（13.6±2.9 与 11.5±3.4g/dl，P<0.0001）方面存在显著差异。死亡组的 E/e'比值明显高于存活组（17.67±3.39 与 10.8±3.30，P<0.001）。生存分析表明，高 E/e'比值（>15.0）比 E/e'比值为 15 及以下预示着更差的预后（Log-Rank 检验 P<0.001）。多变量分析确定了 2 个可预测全因死亡的显著变量：血红蛋白（危险比（HR）=0.806，95%置信区间（CI）=0.733-0.886，P<0.0001）和 E/e' > 15（HR=3.064，95%CI=1.38-6.804，P=0.006）。
E/e'比值是预测左心室射血分数保留的 AF 患者死亡率的一个有用的独立预后参数。
