Fukuda Yamato, Fukuda Nobuo, Morishita Satofumi, Shinohara Hisanori, Yoshida Homare, Yasuda Osamu, Shimoe Yasushi, Tamura Yoshiyuki
J Echocardiogr. 2012 Jun;10(2):41-7. doi: 10.1007/s12574-012-0111-7. Epub 2012 Feb 11.
E/e' and s' are thought to reflect left ventricular diastolic and systolic function, respectively. However, there are no reports on the combined use of E/e' and s' in predicting the outcome in acute myocardial infarction (AMI).
For 20 months beginning in October 2006, we enrolled 65 AMI patients who had undergone Swan-Ganz (SG) catheterization and echocardiography just after reperfusion therapy. We measured the cardiac index (CI) and the pulmonary capillary wedge pressure (PCWP) via an SG catheter and determined routine echocardiographic indices, including transmitral flow velocity (E), mitral annulus velocities at systole (s') and early diastole (e'), and E/e'. In addition, we rounded off the values of s' (cm/s) and E/e' (ratio of cm/s to cm/s) to the nearest integer, and designated them the s'-score and E/e'-score, respectively. We also defined the cardiac status score as the s'-score subtracted from the E/e'-score. In Study 1, we investigated the relationships between hemodynamic parameters (CI and PCWP) and echocardiographic indices, including the cardiac status score. In Study 2, we excluded patients with Killip class ≥II, yielding a final study population of 55 patients in whom we investigated whether the cardiac status score could predict adverse cardiac events.
Only the cardiac status score significantly correlated with both the PCWP and the CI. In the Cox proportional hazards model, significant predictors were the left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and cardiac score ≥3.0.
The novel score achieved in this study by subtracting the s'-score from the E/e'-score could be highly useful for predicting outcomes in AMI with Killip class I.
E/e' 和 s' 分别被认为可反映左心室舒张功能和收缩功能。然而，尚无关于联合使用 E/e' 和 s' 预测急性心肌梗死（AMI）预后的报道。
从2006年10月开始的20个月里，我们纳入了65例急性心肌梗死患者，这些患者在再灌注治疗后即刻接受了 Swan - Ganz（SG）导管插入术和超声心动图检查。我们通过SG导管测量心脏指数（CI）和肺毛细血管楔压（PCWP），并确定常规超声心动图指标，包括二尖瓣血流速度（E）、二尖瓣环收缩期速度（s'）和舒张早期速度（e'）以及E/e'。此外，我们将s'（cm/s）和E/e'（cm/s与cm/s的比值）的值四舍五入到最接近的整数，分别将它们命名为s'评分和E/e'评分。我们还将心脏状态评分定义为E/e'评分减去s'评分。在研究1中，我们研究了血流动力学参数（CI和PCWP）与超声心动图指标（包括心脏状态评分）之间的关系。在研究2中，我们排除了Killip分级≥II级的患者，最终研究人群为55例患者，我们在这些患者中研究心脏状态评分是否可以预测不良心脏事件。
只有心脏状态评分与PCWP和CI均显著相关。在Cox比例风险模型中，显著的预测因素是左心室射血分数（LVEF）、估计肾小球滤过率（eGFR）和心脏评分≥3.0。
本研究中通过从E/e'评分中减去s'评分得到的新评分对于预测Killip I级急性心肌梗死的预后可能非常有用。
