Iwabuchi Yuko, Ogawa Tetsuya, Inoue Tomoko, Otsuka Kuniaki, Nitta Kosaku
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan.
Intern Med. 2012;51(2):155-60. doi: 10.2169/internalmedicine.51.6250. Epub 2012 Jan 15.
We conducted a cohort study to investigate whether diastolic function could predict cardiovascular (CV) events in 161 HD patients with preserved systolic function.
The ratio of early transmitral flow velocity to early mitral annular velocity (E/E') was measured by tissue Doppler imaging. Patients were stratified into two groups based on whether they experienced a CV event.
During a 4-year follow-up period, 64 patients experienced a CV event. The E/E' values (15.18 ± 5.78) in the CV-event group were significantly higher than in the group who had not experienced a CV event (12.32 ± 4.23). Kaplan-Meier analysis indicated that the incidence of CV events was significantly higher in the group of patients whose E/E' was >15 than in the group whose E/E' was ≤ 15 (log-rank p=0.0016). Multivariate Cox proportional hazards regression analysis revealed the E/E' ratio to be a significant predictor of CV events in HD patients with preserved LV systolic function.
The results of this study showed that elevated E/E' ratio in chronic HD patients predicts CV events better than other echocardiographic parameters.
我们开展了一项队列研究，以调查舒张功能是否能够预测161例收缩功能正常的血液透析（HD）患者发生心血管（CV）事件的情况。
采用组织多普勒成像测量二尖瓣血流舒张早期峰值速度与二尖瓣环舒张早期峰值速度之比（E/E'）。根据患者是否发生CV事件将其分为两组。
在4年的随访期内，64例患者发生了CV事件。CV事件组的E/E'值（15.18±5.78）显著高于未发生CV事件的组（12.32±4.23）。Kaplan-Meier分析表明，E/E'＞15的患者组发生CV事件的发生率显著高于E/E'≤15的患者组（对数秩检验p=0.0016）。多变量Cox比例风险回归分析显示，E/E'比值是LV收缩功能正常的HD患者发生CV事件的显著预测指标。
本研究结果表明，慢性HD患者E/E'比值升高对CV事件的预测优于其他超声心动图参数。
