Lassen Mats Christian Højbjerg, Skaarup Kristoffer Grundtvig, Johansen Niklas Dyrby, Olsen Flemming Javier, Qasim Atif N, Jensen Gorm Boje, Schnohr Peter, Møgelvang Rasmus, Biering-Sørensen Tor
Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark.
Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Hellerup, Denmark.
J Am Soc Echocardiogr. 2023 Nov;36(11):1204-1212. doi: 10.1016/j.echo.2023.06.012. Epub 2023 Jun 28.
The ratio of transmitral early filling velocity to early diastolic strain rate (E/e'sr) has recently emerged as a measure of left ventricular filling pressure. Reference values are needed for this new parameter for it to be used clinically.
Healthy participants from a prospective general population study, the Fifth Copenhagen City Heart Study, were assessed to establish reference values for E/e'sr derived from two-dimensional speckle-tracking echocardiography. The prevalence of abnormal E/e'sr was assessed in participants with cardiovascular risk factors or specific diseases.
The population comprised 1,623 healthy participants (median age, 45; interquartile range, 32-56; 61% female). The upper reference limit for E/e'sr in the population was 79.6 cm. Following multivariable adjustment, male participants exhibited significantly higher E/e'sr than female participants (upper reference limit for male participants, 83.7 cm; for female participants, 76.5 cm). For both sexes, E/e'sr increased in a curvilinear fashion with age such that the largest increases in E/e'sr were observed in participants >45 years. In the entire CCHS5 population with E/e'sr available (n = 3,902), increasing age, body mass index, systolic blood pressure, male sex, estimated glomerular filtration rate, and diabetes were associated with E/e'sr (all P < .05). Total cholesterol was associated with a less steep increase in E/e'sr. Abnormal E/e'sr was seldomly observed in participants with normal diastolic function but became more frequent in participants with increasing grades of diastolic dysfunction (normal, mild, moderate, severe [abnormal E/e'sr for each grade: 4.4% vs 20.0% vs 16.2% vs 55.6%, respectively]).
The E/e'sr differs between sexes and is age dependent such that E/e'sr increases with advancing age. Therefore, we established sex- and age-stratified reference values for E/e'sr.
二尖瓣舒张早期血流速度与舒张早期应变率之比（E/e'sr）最近已成为评估左心室充盈压的一项指标。要将这一新参数应用于临床，需要参考值。
对前瞻性普通人群研究——第五届哥本哈根城市心脏研究中的健康参与者进行评估，以确定二维斑点追踪超声心动图得出的E/e'sr的参考值。对有心血管危险因素或特定疾病的参与者评估异常E/e'sr的患病率。
该人群包括1623名健康参与者（年龄中位数45岁；四分位间距32 - 56岁；61%为女性）。该人群中E/e'sr的参考上限为79.6 cm。经过多变量调整后，男性参与者的E/e'sr显著高于女性参与者（男性参与者的参考上限为83.7 cm；女性参与者为76.5 cm）。对于两性而言，E/e'sr均随年龄呈曲线上升，使得E/e'sr增幅最大的是年龄大于45岁的参与者。在整个有E/e'sr数据的CCHS5人群（n = 3902）中，年龄增加、体重指数、收缩压、男性、估计肾小球滤过率和糖尿病均与E/e'sr相关（所有P < 0.05）。总胆固醇与E/e'sr上升幅度较小有关。舒张功能正常的参与者很少观察到异常E/e'sr，但在舒张功能障碍程度增加的参与者中变得更为常见（正常、轻度、中度、重度[各等级异常E/e'sr分别为：4.4% vs 20.0% vs 16.2% vs 55.6%]）。
E/e'sr存在性别差异且与年龄有关，随年龄增长而升高。因此，我们建立了E/e'sr的性别和年龄分层参考值。
