Regional wall motion abnormality at the lateral wall disturbs correlations between tissue Doppler E/e' ratios and left ventricular diastolic performance parameters measured by invasive methods.
Regional wall motion abnormality at the lateral wall disturbs correlations between tissue Doppler E/e' ratios and left ventricular diastolic performance parameters measured by invasive methods.
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DOI：
10.1007/s12574-013-0193-x
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发表时间：
2013
影响因子：
1.6
通讯作者：
Ikari, Yuji
中科院分区：
文献类型：
--
作者：
Fujii, Toshiharu;Yoshioka, Koichiro;Nakano, Masataka;Nakazawa, Gaku;Amino, Mari;Masuda, Naoki;Shinozaki, Norihiko;Kanda, Shigetaka;Ogata, Nobuhiko;Deguchi, Yoshiaki;Yoshimachi, Fuminobu;Ikari, Yuji
局部室壁运动异常（RWMA）对使用E/e′比值（左心室舒张性能的无创参数）诊断射血分数保留性心力衰竭（HFpEF）准确性的影响尚不清楚。本研究旨在探讨左室侧壁RWMA（RWMAlat）对E/e′与左室舒张功能有创参数相关性的影响。回顾性分析了308例连续接受组织多普勒成像和导管压力检查的患者。E/e′计算为舒张早期二尖瓣血流速度与二尖瓣环侧壁血流速度的比值。根据左心室压力研究评估有创参数，包括左心室舒张末期压（LVEDP）和等容舒张时间常数（τ）。分析并比较有无RWMA患者E/e′与上述侵袭性参数的相关系数。308例患者的LVEDP和τ与E/e′均呈良好相关（r = 0.51和r = 0.65）。62名患者有RWMA;其余246名患者没有RWMAlat。我们证实RWMAlat的存在减弱了E/e′与LVEDP（r = 0.574 vs. r = 0.381）和E/e′与τ（r = 0.729 vs. r = 0.461）之间的相关性。虽然E/e′与有创方法评价的左室舒张功能参数相关性良好，但RWMAlat的存在破坏了这种相关性。在有RWMAlat的病例中，需要仔细评估HFpEF诊断，因为与无RWMAlat的患者相比，E/e′比值的诊断价值可能会降低。
The impact of regional wall motion abnormality (RWMA) on the accuracy of heart failure with preserved ejection fraction (HFpEF) diagnosis using the E/e′ ratio, which is a non-invasive parameter of left ventricular diastolic performance, is unknown. The purpose of this study was to elucidate the impact of RWMA of the lateral wall (RWMAlat) on the correlation between E/e′ and invasive parameters of left ventricular diastolic performance. Three hundred and eight consecutive patients undergoing tissue Doppler imaging and catheterization pressure examination were retrospectively analyzed. E/e′ was calculated as the ratio of early diastolic transmitral flow velocity to mitral annular velocity at the lateral wall. Invasive parameters including left ventricular end-diastolic pressure (LVEDP) and isovolumetric relaxation time constant (τ) were assessed based on the left ventricular pressure study. Correlation coefficients between E/e′ and these invasive parameters were analyzed and compared between cases with RWMAlat and without RWMA. LVEDP and τ correlated well with E/e′ for all 308 patients (r = 0.51 and r = 0.65, respectively). Sixty-two patients had RWMA; the remaining 246 did not have RWMAlat. We confirmed that the presence of RWMAlat weakens both the correlations between E/e′ and LVEDP (r = 0.574 vs. r = 0.381), and E/e′ and τ (r = 0.729 vs. r = 0.461). Although E/e′ correlates well with parameters of left ventricular diastolic performance assessed by invasive methods, the presence of RWMAlat worsens this correlation. In cases with RWMAlat, careful assessment is required for HFpEF diagnosis because the diagnostic value of the E/e′ ratio could be decreased compared to patients without RWMAlat.