Department of Cardiology, Herlev and Gentofte University Hospital, Copenhagen, Denmark.
The Copenhagen City Heart Study, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark.
Echocardiography. 2021 Jun;38(6):964-973. doi: 10.1111/echo.15083. Epub 2021 May 16.
The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) may be a more accurate measure of LV filling pressure then ratio of early filling pressure to early tissue velocity. The aim of the study was to investigate the impact of age, sex, obesity, smoking, hypertension, hypercholesterolemia, diabetes, physical activity level, socioeconomic, and psychosocial status on E/e'sr over a decade. Additionally, the predictive value of ΔE/e'sr on future major adverse cardiovascular events (MACE) has never been explored.
The study included 623 participants from the general population, who participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5). Examinations were median 10 years apart. MACE was the composite endpoint of heart failure, myocardial infarction, and all-cause death.
Follow-up time was median 5.7 years, and 43 (7%) experienced MACE. Mean age was 51 ± 14 years, and 43% were male. Mean ΔE/e'sr was 2.1 ± 23.0 cm. After multivariable adjustment for demographic, clinical, and biochemistry variables, high age (stand. β-coef. = .24, P < .001) and mean arterial blood pressure (MAP) (stand. β-coef. = .17, P < .001) were significantly associated with an accelerated increase in E/e'sr In multivariable Cox regression, E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of MACE (HR = 1.20, 95% CI [1.01; 1.42] per 10 cm increase for both). ΔE/e'sr did only provide incremental prognostic value to change in left atrial volume index of the conventional diastolic measurements.
In the general population, age and MAP were predictors of an accelerated increase in E/e'sr over a decade. E/e'sr at CCHS5 and ΔE/e'sr were independent predictors of future MACE.
与早期充盈压与早期组织速度的比值相比，二尖瓣早期充盈速度与早期舒张应变率的比值（E/e'sr）可能是一种更准确的左心室充盈压测量方法。本研究旨在探讨年龄、性别、肥胖、吸烟、高血压、高胆固醇血症、糖尿病、体力活动水平、社会经济和心理社会状况对 E/e'sr 的影响，随访时间长达十年。此外，ΔE/e'sr 对未来主要不良心血管事件（MACE）的预测价值尚未得到探索。
本研究纳入了来自一般人群的 623 名参与者，他们参加了第 4 次和第 5 次哥本哈根城市心脏研究（CCHS4 和 CCHS5）。检查时间中位数相隔 10 年。MACE 是心力衰竭、心肌梗死和全因死亡的复合终点。
中位随访时间为 5.7 年，43 人（7%）发生了 MACE。平均年龄为 51±14 岁，43%为男性。平均 ΔE/e'sr 为 2.1±23.0cm。经过多变量调整，包括人口统计学、临床和生物化学变量后，年龄较大（标准β系数=0.24，P<0.001）和平均动脉压（MAP）较高（标准β系数=0.17，P<0.001）与 E/e'sr 的加速增加显著相关。在多变量 Cox 回归中，CCHS5 时的 E/e'sr 和 ΔE/e'sr 是 MACE 的独立预测因子（HR=1.20，95%CI [1.01; 1.42] 每增加 10cm）。ΔE/e'sr 仅为传统舒张测量的左心房容积指数变化提供了增量预后价值。
在一般人群中，年龄和 MAP 是 E/e'sr 十年内加速增加的预测因子。CCHS5 时的 E/e'sr 和 ΔE/e'sr 是未来 MACE 的独立预测因子。
