Qin Shiyang, Liu Huiling, Cao Xuesong, Zhang Rui
Department of Ultrasound, RinggoldID:117914Affiliated Hospital of Chengde Medical College, Chengde, China.
Department of physical examination, RinggoldID:117914Affiliated Hospital of Chengde Medical College, Chengde, China.
Perfusion. 2023 Apr;38(3):477-483. doi: 10.1177/02676591211058287. Epub 2022 Apr 28.
To explore the clinical value of echocardiography in the assessment of left ventricular diastolic function in patients with acute pulmonary embolism (APE).
APE patients in our hospital from June 2019 to June 2021 were selected as the observation group. They were divided into low-risk group (19 cases), medium-risk group (16 cases) and high-risk group (15 cases). The non-APE people in our hospital during the same period were selected as the control group. All subjects underwent echocardiography to observe the performance of APE patients under echocardiography. The peak velocity ratio S-wave/D-wave (S/D), early diastolic annular velocity/advanced diastolic annular velocity (Ea/Aa), early filling/early diastolic annular velocity (E/Ea), and early filling/early diastolic annular velocity (E/Ea) were compared with Ar and Vp, respectively; receiver operator characteristic (ROC) curve was used to evaluate the value of echocardiography in evaluating left ventricular diastolic function in patients with APE.
Echocardiography show different manifestations of APE patients. Compared with the control group, S/D, Ea/Aa, and Vp in the observation group were significantly decreased and E/Ea and Ar in the observation group were significantly increased ( < 0.05). With the increase of risk stratification, S/D, Ea/Aa, and Vp gradually decreased, E/Ea and Ar gradually increased, and the difference was statistically significant ( < 0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, area under curve (AUC), and 95% were 89.52%, 65.57%, 72.86%, 80.82%, 75.38%, 0.730, and 0.629-0.831, respectively.
Echocardiography can effectively evaluate left ventricular diastolic function in patients with APE, and there are significant differences in left ventricular diastolic function in different risk stratification, which has important reference value for clinical diagnosis and treatment of APE.
探讨超声心动图在评估急性肺栓塞(APE)患者左心室舒张功能中的临床价值。
选取2019年6月至2021年6月我院的APE患者作为观察组,分为低危组(19例)、中危组(16例)和高危组(15例)。选取同期我院非APE患者作为对照组。所有受试者均接受超声心动图检查,观察APE患者在超声心动图下的表现。比较S波峰值速度/D波峰值速度(S/D)、舒张早期环向速度/舒张晚期环向速度(Ea/Aa)、早期充盈/舒张早期环向速度(E/Ea)以及早期充盈/舒张早期环向速度(E/Ea)与Ar和Vp;采用受试者操作特征(ROC)曲线评估超声心动图在评估APE患者左心室舒张功能中的价值。
超声心动图显示APE患者有不同表现。与对照组相比,观察组的S/D、Ea/Aa和Vp显著降低,观察组的E/Ea和Ar显著升高(P<0.05)。随着危险分层增加,S/D、Ea/Aa和Vp逐渐降低,E/Ea和Ar逐渐升高,差异有统计学意义(P<0.05)。敏感性、特异性、准确性、阳性预测值、阴性预测值、曲线下面积(AUC)及95%可信区间分别为89.52%、65.57%、72.86%、80.82%、75.38%、0.730及0.629 - 0.831。
超声心动图可有效评估APE患者的左心室舒张功能,不同危险分层的左心室舒张功能存在显著差异,对APE的临床诊断和治疗具有重要参考价值。