双脉冲多普勒超声心动图技术测量E／（e’×s）评价冠心病患者左心室舒张功能  

Value of evaluating diastolic function with the single-beat E/（e＇×s） obtained by dual doppler echocardiograph in coronary heart disease patients with preserved left ventricular systolic function

作　　者：汪晶晶[1] 陈韵岱[1] 王晶[1] 惠海鹏[1] 智光[1] 穆洋[1] 

机构地区：[1]解放军总医院心血管内科,北京100853

出　　处：《中华心血管病杂志》2014年第4期305-308,共4页Chinese Journal of Cardiology

摘　　要：目的探讨双脉冲多普勒超声心动图技术测量的舒张早期二尖瓣血流峰值速度（E）／[舒张早期二尖瓣瓣环峰值速度（e’）×收缩期二尖瓣瓣环峰值速度（S）]诊断冠心病患者左心室舒张功能不全的准确性。方法连续人选左心室射血分数正常的冠心病患者77例。采用双脉冲多普勒超声心动图技术测量同一心动周期E／（e’×s）和E／e’。患者均行心导管检查，测量左心室舒张末期压力。分析E／（e’×S）和E／e’与左心室舒张末期压力的相关性，并分别评估E／（e’×s）、E／（e’×s）联合E／e’诊断左心室舒张功能不全[指左心室舒张末期压力≥12mmHg（1mmHg=0．133kPa）]的准确性。结果（1）Pearson相关分析显示，E／（e’×S）和E／e’与左心室舒张末期压力均相关（r值分别为0．68和0．79，P均〈0．01）。（2）E／（e’×s）≥1．2时，诊断左心室舒张功能不全的敏感度为80％，特异度为77％，受试者工作特征（ROC）曲线下面积为0．85；E／e’≥9．2时，诊断左心室舒张功能不全的敏感度为74％，特异度为81％，ROC曲线下面积为0．87；联合E／（e’×s）≥1．2与E／e’i〉9．2时，诊断左心室舒张功能不全的敏感度为83％，特异度为7l％，ROC曲线下面积为0．87。结论双脉冲多普勒超声心动图技术测量的E／（e’×s）能较准确地评估冠心病患者的左心室舒张功能，E／（e’×s）联合E／e’未能提高诊断舒张功能不全的价值。Objective To assess the value of E/（e＇×s） in estimating left ventricular diastolic dysfunction in patients with coronary heart disease by dual Doppler echocardiograph. Methods Seventy- seven consecutive coronary heart disease patients with preserved systolic function underwent echocardiographic study were included. The E, e＇and s were obtained by the dual Doppler echocardiography and E/（e＇×s）, E/e＇ were calculated. All patients underwent left ventricular catheterization to measure left ventricular end diastolic pressure （LVEDP）. The relationship between E/（e＇×s）, E/e＇ and LVEDP were analyzed. Patients were divided into normal diastolic function （LVEDP 〈 12 mmI-Ig, 1 mmHg = 0. 133 kPa） and diastolic dysfunction group （LVEDP ≥ 12 mmHg）. Results （1） Pearson correlation analysis showed that both E/（ e＇ x s） and E/e＇ correlated well with LVEDP （ r = 0. 68 and r = 0. 79, both P 〈 0. 01 ）. （2） Using receiver operating characteristic analysis, the optimal cut-off for E/（e＇×s） was 1.2 （sensitivity was 80% ,specificity was 77%, AUC was 0. 85） and for E/e＇ was 9. 2 （sensitivity was 74%, specificity was 81% , AUC was 0. 87 ） to predict left ventricular diastolic dysfunction. When combined cut-offs of E/（e＇×s） ≥1.2 and E/e＇≥9.2, the sensitivity and specificity of predicting left ventricular diastolic dysfunction were 83% and 71% respectively, and AUC was 0. 87. Conclusions E/（e＇×s）can correctly reflect diastolic function status in patients with coronary artery disease. However, combined use of E/（e＇×s）and E/e＇ does not add the prediction value on diastolic dysfunction in this patient cohort.

关 键 词：心室功能障碍 左 超声心动描记术 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]