Brunckhorst C, Lange H W, Aschenberg W, Rehpenning W, Bleifeld W
University Hospital Eppendorf, Department of Cardiology, Hamburg, West Germany.
Clin Cardiol. 1990 Feb;13(2):108-14. doi: 10.1002/clc.4960130209.
To determine the relation between presence and severity of coronary artery disease and diastolic filling abnormalities by Doppler echocardiography, recordings of transmitral inflow velocity were made at rest in 90 patients with coronary artery disease and 28 normals. At the time of the Doppler examination, 81 patients with coronary artery disease (90%) and 10 normals (36%) were treated with antianginal medications. No difference was found in the ratio between early (E) and late (A) diastolic filling velocity (E/A ratio) when comparing patients with greater than 70% obstruction of at least one coronary artery to age-matched normals, regardless of the presence or absence of wall motion abnormalities. The E/A ratio was 1.3 +/- 0.46 in coronary patients with normal wall motion, 1.2 +/- 0.47 in coronary patients with abnormal wall motion, and 1.3 +/- 0.53 in both samples of age-matched normals. Multivariate analysis of the relation between E/A ratio and other variables showed that heart rate (F = 24.46, p less than 0.00001) and age (F = 19.51, p less than 0.00001) were significant independent determinants of the E/A ratio, while the presence or severity of coronary artery disease, the presence of hypertension, the magnitude of wall motion abnormalities, and end-diastolic dimension by echocardiography were not. These data suggest that transmitral inflow velocity recordings by Doppler have limited value for the recognition of coronary artery disease, since the E/A ratio is profoundly influenced by other factors, such as heart rate and age.
为通过多普勒超声心动图确定冠状动脉疾病的存在及严重程度与舒张期充盈异常之间的关系，对90例冠状动脉疾病患者和28例正常人在静息状态下进行了二尖瓣血流速度记录。在进行多普勒检查时，81例冠状动脉疾病患者（90%）和10例正常人（36%）正在接受抗心绞痛药物治疗。在比较至少一支冠状动脉阻塞大于70%的患者与年龄匹配的正常人时，无论是否存在室壁运动异常，舒张早期（E）和晚期（A）充盈速度之比（E/A比值）均未发现差异。室壁运动正常的冠心病患者E/A比值为1.3±0.46，室壁运动异常的冠心病患者为1.2±0.47，年龄匹配的正常人群样本中该比值为1.3±0.53。对E/A比值与其他变量之间关系的多因素分析显示，心率（F = 24.46，p＜0.00001）和年龄（F = 19.51，p＜0.00001）是E/A比值的重要独立决定因素，而冠状动脉疾病的存在或严重程度、高血压的存在、室壁运动异常的程度以及超声心动图测量的舒张末期内径则不是。这些数据表明，由于E/A比值受心率和年龄等其他因素的深刻影响，多普勒记录的二尖瓣血流速度对识别冠状动脉疾病的价值有限。
