Zamfirescu Marilena-Brîndușa, Ghilencea Liviu-Nicolae, Popescu Mihaela-Roxana, Bejan Gabriel Cristian, Maher Sean Martin, Popescu Andreea-Catarina, Dorobanțu Maria
Cardiothoracic Pathology Department, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of Cardiology, Elias Emergency University Hospital, 011461 Bucharest, Romania.
Medicina (Kaunas). 2021 Apr 13;57(4):375. doi: 10.3390/medicina57040375.
: Heart failure with preserved ejection fraction (HFpEF) remains a worldwide management problem. Although there is a general effort for characterizing this population, few studies have assessed the predictive value of the echocardiographic E/e' ratio in patients with acute HFpEF. The aim of the study was to identify groups with different prognosis in patients hospitalized with a first acute episode of HFpEF. : The primary endpoint of the study was heart failure readmissions (HFR) at 6 months, while the secondary outcome was six-month mortality. We consecutively enrolled 91 patients hospitalized for the first time with acute HFpEF. We examined the E/e' ratio as an independent predictor for HFR using univariate regression. : We identified and validated the E/e' ratio as an independent predictor for HFR. An E/e' ratio threshold value of 13.80 was calculated [(area under the receiver operating characteristic curve (AUROC) = 0.693, sensitivity = 78.60%, specificity = 55%, < 0.004)] and validated as an inflection point for an increased number of HFR. Thus, we divided the study cohort into two groups: group 1 with an E/e' ratio < 13.80 (n = 39) and group 2 with an E/e' ratio > 13.80 (n = 49). Compared to group 1, group 2 had an increased number of HFR ( = 0.003) and a shorter time to first HFR ( = 0.002). However, this parameter did not influence all-cause mortality within six months ( = 0.84). : The dimensionless E/e' ratio is a useful discriminator between patients with acute HFpEF. An E/e' value over 13.80 represents a simple, yet effective instrument for assessing the HFR risk. However, all-cause mortality at six months is not influenced by the E/e' ratio.
射血分数保留的心力衰竭（HFpEF）仍然是一个全球性的治疗难题。尽管人们普遍致力于对这一人群进行特征描述，但很少有研究评估超声心动图E/e'比值在急性HFpEF患者中的预测价值。本研究的目的是在首次因急性HFpEF发作而住院的患者中识别出具有不同预后的群体。：本研究的主要终点是6个月时的心力衰竭再入院率（HFR），次要结局是6个月死亡率。我们连续纳入了91例首次因急性HFpEF住院的患者。我们使用单变量回归分析将E/e'比值作为HFR的独立预测因子进行研究。：我们确定并验证了E/e'比值是HFR的独立预测因子。计算出E/e'比值阈值为13.80[受试者工作特征曲线下面积（AUROC）=0.693，灵敏度=78.60%，特异性=55%，P<0.004]，并验证其为HFR增加数量的转折点。因此，我们将研究队列分为两组：E/e'比值<13.80的第1组（n=39）和E/e'比值>13.80的第2组（n=49）。与第1组相比，第2组的HFR数量增加（P=0.003），首次HFR的时间更短（P=0.002）。然而，该参数对6个月内的全因死亡率没有影响（P=0.84）。：无量纲的E/e'比值是急性HFpEF患者之间有用的鉴别指标。E/e'值超过13.80代表一种简单但有效的评估HFR风险的工具。然而，6个月时的全因死亡率不受E/e'比值的影响。
