Hoshida Shiro
Department of Cardiovascular Medicine, Yao Municipal Hospital, 1-3-1 Ryuge-cho, Osaka 581-0069, Japan.
J Clin Med. 2023 Oct 23;12(20):6692. doi: 10.3390/jcm12206692.
Of the existing non-invasive diastolic indices, none consider arterial load. This article reveals points of caution for determining the diastolic prognostic index using a novel index of vascular resistance-integrated diastolic function in old, real-world patients with heart failure with preserved ejection fraction (HFpEF) in Japan. This index represents the ratio of left ventricular diastolic elastance (Ed) to arterial elastance (Ea), where Ed/Ea = (E/e')/(0.9 × systolic blood pressure), showing a relative ratio of left atrial filling pressure to left ventricular end-systolic pressure. The role of hemodynamic prognostic factors related to diastolic function, such as Ed/Ea, may differ according to the clinical endpoint, follow-up duration, and sex. In HFpEF patients with heterogenous cardiac structure and function, an assessment using a serial echocardiographic diastolic index in clinical care can provide an accurate prognosis.
在现有的非侵入性舒张功能指标中，没有一个考虑动脉负荷。本文揭示了在日本老年、真实世界的射血分数保留的心力衰竭（HFpEF）患者中，使用一种新的血管阻力综合舒张功能指标来确定舒张期预后指标时需要注意的要点。该指标代表左心室舒张弹性（Ed）与动脉弹性（Ea）的比值，其中Ed/Ea = （E/e'）/（0.9×收缩压），显示左心房充盈压与左心室收缩末期压力的相对比值。与舒张功能相关的血流动力学预后因素（如Ed/Ea）的作用可能因临床终点、随访时间和性别而异。在心脏结构和功能各异的HFpEF患者中，在临床护理中使用连续超声心动图舒张功能指标进行评估可以提供准确的预后。
