Hospital Cardiológico Costantini, Curitiba, PR, Brazil.
Arq Bras Cardiol. 2013 Jun;100(6):531-7. doi: 10.5935/abc.20130092. Epub 2013 May 7.
Left ventricular (LV) dilation after acute myocardial infarction (AMI) is an important determinant of prognosis. The ratio of early mitral inflow velocity (E) and peak early diastolic annular velocity (e') provides the best single index for noninvasive detection of acute elevation of LV filling pressure.
To assess whether E/e' ratio predicts LV remodeling after properly treated AMI compared with traditional clinical, laboratory and echocardiographic data.
Comprehensive echocardiograms were performed in a series of consecutive patients with first AMI successfully treated with primary percutaneous transluminal angioplasty (PTCA), both 48 hours after intervention and 60 days later. Mean E/e' was determined from four sites of the mitral annulus. LV remodeling was defined as more than 15% increase in end-systolic volume estimated by Simpson method. Statistical analysis included Student's t test, receiver-operator curves (ROC) and multivariate logistic regression (all significant with p < 0.05).
Fifty-five patients were included, with mean age 58 ± 11 years, 43 men. The group of patients who underwent LV remodeling (n = 13) had higher baseline E/e' than those without (13 ± 4 versus 8.5 ± 2, p < 0.001). The ROC curve showed E/e' > 15 as a predictor of remodeling (AUC = 0.81, p = 0.001). In addition, regression analysis (comprising clinical, laboratory and echocardiographic variables along with AMI site) confirmed the independent value of E/e' in the prediction of LV remodeling (odds ratio 1.42, p = 0.01).
The E/e' ratio is a useful predictor of LV remodeling after AMI, indicating patients with increased cardiovascular risk.
急性心肌梗死（AMI）后左心室（LV）扩张是预后的重要决定因素。早期二尖瓣流入速度（E）与早期舒张期瓣环速度峰值（e'）的比值提供了无创检测 LV 充盈压急性升高的最佳单一指标。
评估在适当治疗 AMI 后，E/e'比值是否比传统临床、实验室和超声心动图数据更能预测 LV 重构。
对一系列首次接受经皮腔内冠状动脉成形术（PTCA）成功治疗的 AMI 连续患者进行全面超声心动图检查，分别在干预后 48 小时和 60 天后进行。从二尖瓣环的四个部位确定平均 E/e'。LV 重构定义为 Simpson 法估计的收缩末期容积增加超过 15%。统计分析包括学生 t 检验、接受者操作特征曲线（ROC）和多变量逻辑回归（所有有意义的 p < 0.05）。
55 例患者入选，平均年龄 58 ± 11 岁，43 例男性。发生 LV 重构的患者（n = 13）的基线 E/e'高于未发生重构的患者（13 ± 4 与 8.5 ± 2，p < 0.001）。ROC 曲线显示 E/e' > 15 可预测重构（AUC = 0.81，p = 0.001）。此外，回归分析（包括临床、实验室和超声心动图变量以及 AMI 部位）证实 E/e'在预测 LV 重构中的独立价值（比值比 1.42，p = 0.01）。
E/e'比值是 AMI 后 LV 重构的有用预测指标，表明患者心血管风险增加。
