CAJ | 학술논문

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.方法连续入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≥12 mmHg(1 mmHg=0.133 kPa)]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’≥9.2时,诊断左心室舒张功能不全的敏感度为83％,特异度为71％,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.
목적 탐토쌍맥충다보륵초성심동도기술측량적서장조기이첨판혈류봉치속도(E)/[서장조기이첨판판배봉치속도(e’)×수축기이첨판판배봉치속도(s)]진단관심병환자좌심실서장공능불전적준학성.방법 련속입선좌심실사혈분수정상적관심병환자77례.채용쌍맥충다보륵초성심동도기술측량동일심동주기E/(e'×s)화E/e’.환자균행심도관검사,측량좌심실서장말기압력.분석E/(e’×s)화E/e’여좌심실서장말기압력적상관성,병분별평고E/(e’×s)、E/(e'×s)연합E/e’진단좌심실서장공능불전[지좌심실서장말기압력≥12 mmHg(1 mmHg=0.133 kPa)]적준학성.결과 (1)Pearson상관분석현시,E/(e’×s)화E/e’여좌심실서장말기압력균상관(r치분별위0.68화0.79,P균＜0.01).(2)E/(e '×s)≥1.2시,진단좌심실서장공능불전적민감도위80％,특이도위77％,수시자공작특정(ROC)곡선하면적위0.85;E/e’≥9.2시,진단좌심실서장공능불전적민감도위74％,특이도위81％,ROC곡선하면적위0.87;연합E/(e'×s)≥1.2여E/e’≥9.2시,진단좌심실서장공능불전적민감도위83％,특이도위71％,ROC곡선하면적위0.87.결론 쌍맥충다보륵초성심동도기술측량적E/(e’×s)능교준학지평고관심병환자적좌심실서장공능,E/(e’×s)연합E/e’미능제고진단서장공능불전적개치.
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 Seventyseven 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 mmHg,1 mmHg =0.133 kPa) and diastolic dysfunction group (LVEDP ≥ 12 mmHg).Results (1) Pearson correlation analysis showed that both E/(e' × 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.