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[双多普勒超声心动图获得的单搏E/(e'×s)评估左心室收缩功能保留的冠心病患者舒张功能的价值]

[Value of evaluating diastolic function with the single-beat E/(e'×s) obtained by dual doppler echocardiograph in coronary heart disease patients with preserved left ventricular systolic function].

作者信息

Wang Jingjing, Chen Yundai, Wang Jing, Hui Haipeng, Zhi Guang, Mu Yang

机构信息

Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China. Email:

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Apr;42(4):305-8.

Abstract

OBJECTIVE

To assess the value of E/(e'×s) in estimating left ventricular diastolic dysfunction in patients with coronary heart disease by dual Doppler echocardiograph.

METHODS

Seventy-seven consecutive coronary heart disease patients with preserved systolic function underwent echocardiographic study were included. The E, e'and s were obtained by the dual Doppler echocardiography and E/(e'×s), E/e' were calculated. All patients underwent left ventricular catheterization to measure left ventricular end diastolic pressure (LVEDP). The relationship between E/(e'×s), E/e' and LVEDP were analyzed. Patients were divided into normal diastolic function (LVEDP < 12 mmHg, 1 mmHg = 0.133 kPa) and diastolic dysfunction group (LVEDP ≥ 12 mmHg) .

RESULTS

(1) Pearson correlation analysis showed that both E/(e'×s) and E/e' correlated well with LVEDP (r = 0.68 and r = 0.79, both P < 0.01). (2)Using receiver operating characteristic analysis, the optimal cut-off for E/(e'×s) was 1.2(sensitivity was 80%, specificity was 77%,AUC was 0.85) and for E/e' was 9.2(sensitivity was 74%, specificity was 81%,AUC was 0.87) to predict left ventricular diastolic dysfunction. When combined cut-offs of E/(e'×s) ≥ 1.2 and E/e' ≥ 9.2, the sensitivity and specificity of predicting left ventricular diastolic dysfunction were 83% and 71% respectively, and AUC was 0.87.

CONCLUSIONS

E/(e'×s) can correctly reflect diastolic function status in patients with coronary artery disease. However, combined use of E/(e'×s)and E/e' does not add the prediction value on diastolic dysfunction in this patient cohort.

摘要

目的

采用双多普勒超声心动图评估E/(e'×s)对冠心病患者左心室舒张功能障碍的评估价值。

方法

纳入77例连续的收缩功能正常的冠心病患者进行超声心动图研究。通过双多普勒超声心动图获取E、e'和s,并计算E/(e'×s)、E/e'。所有患者均接受左心室导管检查以测量左心室舒张末期压力(LVEDP)。分析E/(e'×s)、E/e'与LVEDP之间的关系。将患者分为舒张功能正常组(LVEDP<12 mmHg,1 mmHg = 0.133 kPa)和舒张功能障碍组(LVEDP≥12 mmHg)。

结果

(1)Pearson相关性分析显示,E/(e'×s)和E/e'与LVEDP均具有良好的相关性(r = 0.68和r = 0.79,均P<0.01)。(2)采用受试者工作特征分析,预测左心室舒张功能障碍时,E/(e'×s)的最佳截断值为1.2(敏感性为80%,特异性为77%,AUC为0.85),E/e'的最佳截断值为9.2(敏感性为74%,特异性为81%,AUC为0.87)。当E/(e'×s)≥1.2和E/e'≥9.2联合截断值时,预测左心室舒张功能障碍的敏感性和特异性分别为83%和71%,AUC为0.87。

结论

E/(e'×s)可正确反映冠心病患者的舒张功能状态。然而,在该患者队列中,联合使用E/(e'×s)和E/e'并未增加对舒张功能障碍的预测价值。

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