摘要
目的评价二尖瓣舒张早期血流峰速度（E）与二尖瓣环舒张早期运动峰速度（E＇）比值（E/E＇）对心房颤动（房颤）患者左心房压力（LAP）的诊断价值。方法本研究为横断面研究，连续纳入2017年5至7月于北京协和医院住院并首次行射频消融术、左心室射血分数正常的非瓣膜性房颤患者46例。所有入选者术前24~48 h行超声心动图检查，消融术中通过心导管测定LAP。根据术中心导管测得的LAP将患者分为2组，即LAP正常组31例（平均LAP≤12 mmHg，1 mmHg=0.133 kPa）和LAP升高组15例（平均LAP〉12 mmHg）。采用Pearson相关分析评价超声心动图各参数与平均LAP的相关性，采用受试者工作特征（ROC）曲线评价E/E＇对于LAP升高的诊断价值。结果间隔E/E＇、侧壁E/E＇、平均E/E＇均与心导管测得的平均LAP呈显著正相关，r值分别为0.397、0.433、0.431，P均〈0.05。ROC曲线分析显示，E/E＇诊断平均LAP〉 12 mmHg的最佳界值分别为间隔E/E＇〉12.5（敏感度73.3%，特异度67.7%），侧壁E/E＇〉10.8（敏感度80.0%，特异度77.4%），平均E/E＇〉11.0（敏感度86.7%，特异度64.5%）。结论超声心动图参数E/E＇与房颤患者LAP具有良好的相关性，对LAP升高具有较好的诊断价值，尤其是侧壁E/E＇，其有助于临床上对房颤患者舒张功能的评价。
Objective To evaluate the association between the ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity （E/E＇） and left atrial pressure （LAP） estimated from invasive catheter measurements in patients with atrial fibrillation （AF）. Methods A total of 46 consecutive patients with non-valvular AF and preserved left ventrieular ejection fraction （LVEF） admitted in our department to receive the first radiofrequency ablation from May to July 2017 were included. All patients underwent eehoeardiography at 24-48 hours before radiofrequeney ablation, and LAP was invasively measured during the ablation procedure. According to mean LAP, patients were divided into 2 groups of normal LAP （LAP≤ 12 mmHg（1 mmHg=0.133 kPa, n=31） and elevated LAP （LAP〉12 mmHg, n=15）. Linear correlation analysis was used to evaluate the relationship between E/E＇ and LAP. Results E/E＇ correlated well with LAP （septal E/E＇ （E/E＇sep）, r= 0.397, P=0.006; lateral E/E＇ （E/E＇lat）, r=0.433, P=0.003; mean E/E＇ （E/E＇mean）, r=0.431, P= 0.003）. Using receiver operating characteristic analysis, the optimal cut-off for E/E＇sep, was 12.5 （sensitivity 73.3%, specificity 67.7% ）, E/E＇lat was 10.8 （sensitivity 80.0%, specificity 77.4%）, E/E＇mean. was 11.0 （sensitivity 86.7%, specificity 64.5%） to predict mean LAP≤12 mmHg. Conclusion E/E＇ , especially the E/E＇, is positively correlated with LAP in patients with AF and preserved LVEF, and may be used to estimate the diastolic function in AF patients with preserved LVEF.
作者
马改改
方理刚
高鹏
程中伟
陈太波
林雪
程康安
邓华
方全
Ma Gaigai;Fang Ligang;Gao Peng;Cheng Zhongwei;Chen Taibo;Lin Xue;Cheng Kang＇an;Deng Hua;Fang Quan(Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China)
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2018年第4期292-297,共6页
Chinese Journal of Cardiology
关键词
心房颤动
超声心动描记术
压力
诊断
左心房压力
Atrial fibrillation
Echocardiography,stress
Diagnosis
Left atrial pressure
