Pugliese Nicola Riccardo, Fabiani Iacopo, La Carrubba Salvatore, Carerj Scipione, Conte Lorenzo, Colonna Paolo, Caso Pio, Benedetto Frank, Antonini-Canterin Francesco, Romano Maria Francesca, Citro Rodolfo, Di Bello Vitantonio
Cardio Thoracic and Vascular Department, University of Pisa, Pisa, Italy.
Villa Sofia Hospital, Palermo, Italy.
J Cardiovasc Echogr. 2018 Apr-Jun;28(2):95-100. doi: 10.4103/jcecho.jcecho_59_17.
Doppler echocardiography with early diastolic transmitral velocity (E)/early mitral annular diastolic velocity (E') ratio has been proposed as the best predictor for evaluating left ventricle (LV) filling pressure. A dimensionless index E/(E' × S') ratio (S' = systolic mitral annulus velocity) resulted in readily, reproducible, and reliable predictor of LV filling pressure. We assessed the prognostic impact of E/E' × S') in patients with asymptomatic heart failure (HF).
We calculated E/(E' × S') in 337 patients (179 male, 53%; age 54.7 ± 13.7 years) using the average of septal and lateral mitral annular velocities. We considered a composite endpoint as follows: all-cause death, acute myocardial infarction, stroke, and HF exacerbation.
Baseline ejection fraction resulted 60.2 ± 11.8%; E/E' × S') was 1.45 ± 0.8, with S' 7.4 ± 2.4 cm/s and E/E' 9.5 ± 5.4. After a 22-month median follow-up, there were 42 events: 5 deaths (12%), 3 acute myocardial infarctions (7%), 1 stroke (2%), and 33 HF hospitalizations (79%). In patients reaching the composite endpoint, E/(E' × S') resulted 2.07 ± 1.1 versus 1.3 ± 0.7 in event-free population ( < 0.001). In a Cox-regression analysis, adjusted for confounding clinical factors and conventional echo parameters, E/(E' × S') ( < 0.001), age ( < 0.001), and male gender ( = 0.03) resulted independent predictors of the composite endpoint.
E/(E' × S') was an independent predictor for the future cardiac events in asymptomatic HF.
舒张早期经二尖瓣血流速度（E）与二尖瓣环舒张早期速度（E'）比值的多普勒超声心动图已被提议作为评估左心室（LV）充盈压的最佳预测指标。无量纲指数E/（E'×S'）比值（S' = 二尖瓣环收缩期速度）成为了评估LV充盈压简便、可重复且可靠的预测指标。我们评估了E/（E'×S'）对无症状心力衰竭（HF）患者预后的影响。
我们使用二尖瓣环间隔侧和侧壁速度的平均值，计算了337例患者（179例男性，占53%；年龄54.7±13.7岁）的E/（E'×S'）。我们将以下情况视为复合终点：全因死亡、急性心肌梗死、中风和HF加重。
基线射血分数为60.2±11.8%；E/（E'×S'）为1.45±0.8，S'为7.4±2.4 cm/s，E/E'为9.5±5.4。经过22个月的中位随访，发生了42起事件：5例死亡（12%），3例急性心肌梗死（7%），1例中风（2%），33例HF住院（79%）。在达到复合终点的患者中，E/（E'×S'）为2.07±1.1，而在无事件人群中为1.3±0.7（P<0.001）。在一项Cox回归分析中，校正混杂的临床因素和传统超声心动图参数后，E/（E'×S'）（P<0.001）、年龄（P<0.001）和男性性别（P = 0.03）是复合终点的独立预测因素。
E/（E'×S'）是无症状HF患者未来心脏事件的独立预测因素。
