Department of Cardiology, The Heart Center, Rigshospitalet - University Hospital of Copenhagen, Copenhagen, Denmark.
Cardiovascular Research Unit, University of Southern Denmark, Svendborg, Denmark.
Echocardiography. 2024 Sep;41(9):e15917. doi: 10.1111/echo.15917.
Echocardiographic diastolic parameters are used to diagnose and monitor increased left ventricular filling pressure (LVFP) and we hypothesized that increased loading conditions cause increased E/e'. Our aim was to assess the effect of preload augmentation on diastolic parameters among both healthy subjects and subjects with known cardiac disease.
We included 129 subjects merged from two cohorts; one dialysis cohort (n = 47) and one infusion cohort (n = 82). Echocardiography was performed immediately before and after hemodialysis (HD) or saline infusion, under low and high loading conditions. Elevated LVFP was defined as septal E/e' ≥ 15 and/or lateral E/e' ≥ 13 at high-loading conditions. The population was divided according to elevated LVFP (n = 31) and normal LVFP (n = 98). The load difference for the population was 972 ± 460 mL, with no differences in load difference between elevated and normal LVFP (p NS). The subjects with elevated LVFP were older (63 ± 11 vs. 46 ± 16 years, p < .001), and had lower LV ejection fraction (50 ± 14 vs. 59 ± 8.1%, p < .01). After augmented preload, EDV increased in the normal LVFP group (p < .01) but remained unchanged in the elevated LVFP group (p NS). Both E and e' increased among the subjects with normal LVFP, whereas E/e' remained unchanged (∆E/e' +.1 [-.5-1.2]), p NS). Among the subjects with elevated, LVFP we observed increased E but not e', resulting in significantly increased E/e' (∆ average E/e' +2.4 [0-4.0], p < .01).
Augmented preload does not seem to affect E/e' among subjects with normal LVFP, whereas E/e' seems to increase significantly among subjects with elevated LVFP.
超声心动图舒张参数用于诊断和监测左心室充盈压（LVFP）升高，我们假设负荷增加会导致 E/e'增加。我们的目的是评估在健康受试者和已知心脏病患者中，前负荷增加对舒张参数的影响。
我们合并了两个队列的 129 名受试者；一个透析队列（n=47）和一个输液队列（n=82）。在低负荷和高负荷条件下，在血液透析（HD）或生理盐水输注前后立即进行超声心动图检查。在高负荷条件下，LVFP 升高定义为间隔 E/e'≥15 和/或侧壁 E/e'≥13。根据 LVFP 升高（n=31）和正常 LVFP（n=98）将人群分为两组。人群的负荷差异为 972±460mL，LVFP 升高和正常组之间的负荷差异无统计学差异（p NS）。LVFP 升高的受试者年龄较大（63±11 岁比 46±16 岁，p<0.001），LV 射血分数较低（50±14%比 59±8.1%，p<0.01）。在前负荷增加后，正常 LVFP 组的 EDV 增加（p<0.01），而 LVFP 升高组无变化（p NS）。正常 LVFP 组的 E 和 e'均增加，而 E/e'不变（∆E/e' +.1 [-.5-1.2]，p NS）。在 LVFP 升高的受试者中，我们观察到 E 增加，但 e'没有增加，导致 E/e'显著增加（∆平均 E/e' +2.4 [0-4.0]，p<0.01）。
前负荷增加似乎不会影响正常 LVFP 受试者的 E/e'，而 LVFP 升高的受试者的 E/e'似乎显著增加。
