Study of the Correlation Between the Ratio of Diastolic to Systolic Durations and Echocardiography Measurements and Its Application to the Classification of Heart Failure Phenotypes.
Study of the Correlation Between the Ratio of Diastolic to Systolic Durations and Echocardiography Measurements and Its Application to the Classification of Heart Failure Phenotypes.
复制标题
舒张期与收缩期持续时间之比与超声心动图测量之间的相关性研究及其在心力衰竭表型分类中的应用
DOI：
10.2147/ijgm.s324319
复制
发表时间：
2021
影响因子：
2.3
通讯作者：
Qin J
中科院分区：
文献类型：
--
作者：
Cheng L;Liao K;Wang Y;Lv F;Guo X;Zheng Y;Qin J
背景本研究旨在探讨慢性心力衰竭患者舒缩间期比值(D/S)与超声心动图参数的相关性，探讨D/S能否作为心力衰竭表型分类的辅助生物标志物。方法12 2例左心室射血分数<40%、4 0%≤<5 0%或≥<5 0%的充血性心力衰竭患者分为心衰伴射血分数降低组(N=32)、心衰伴中段射血分数组(N=2 1)和心力衰竭伴射血分数保留组(N=69)。超声心动图检测19个结构和功能参数，数字化心动图测定D/S。采用Spearman相关分析D/S与超声心动图参数的相关性。用多因素Logistic回归分析D/S与HF表型的关系，用受试者工作特征曲线分析D/S在HF表型分类中的预测价值。结果HFrEF、HFmrEF和HFpEF患者的D/S分别为1.32±0.06、1.44±0.11和1.54±0.08，差异有统计学意义(均P<0.05)。D/S与左心室射血分数密切相关(r=0.777，P<；0.001)。多因素分析显示D/S是CHF表型的独立危险因素(OR=4.927，95%CI为2.532~9.587；P<；0.001)。用D/S判别高频射血分数与高频射血分数的ROC曲线下面积为0.764(95%CI 0.707~0.845；P <；0.001)；用D/S判别高频射血分数与高频射血分数的ROC曲线下面积为0.821(95%CI 0.755~0.882；P <；0.001)。结论D/S与左心室射血分数显著相关，且随着左心室射血分数的降低，D/S有下降的趋势，可作为无创性检测心脏收缩和舒张期功能不全的辅助指标。
Background This study aimed to investigate the correlation between the ratio of diastolic to systolic durations (D/S) and echocardiographic parameters of patients with chronic heart failure (CHF) and evaluate whether the D/S can be used as a supplementary biomarker for the classification of heart failure (HF) phenotypes. Methods In total, 122 CHF patients with a left ventricular ejection fraction (LVEF) <40%, 40%≤LVEF<50%, or ≥50% were categorized as having HF with a reduced ejection fraction (HFrEF) (N=32), HF with a mid-range ejection fraction (HFmrEF) (N=21) or HF with a preserved ejection fraction (HFpEF) (N=69), respectively. All patients underwent echocardiography for assessment of nineteen structural and functional echocardiographic parameters and digital phonocardiography for the measurement of D/S. Spearman correlation was used to analyse the associations between the D/S and echocardiographic parameters. Multivariate logistic regression analysis was performed to examine the associations between the D/S and HF phenotypes, and receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive value of the D/S in the classification of HF phenotypes. Results The D/S values of patients with HFrEF, HFmrEF and HFpEF were 1.32±0.06, 1.44±0.11 and 1.54±0.08, respectively, which were significantly different (All P<0.05). A close correlation between the D/S and LVEF was found (r=0.777, P<0.001). The multivariate analysis indicated that the D/S was an independent risk factor for CHF phenotypes (OR=4.927, 95% CI 2.532–9.587; P<0.001). The area under the ROC curve for distinguishing between HFmrEF and HFpEF using the D/S was 0.764 (95% CI 0.707–0.845; P < 0.001) and that for distinguishing between HFmrEF and HFrEF using the D/S was 0.821 (95% CI 0.755–0.882; P < 0.001). Conclusion The D/S was significantly associated with LVEF, and as LVEF decreased, the D/S tended to decrease, which could also serve as a noninvasive supplementary indicator for detecting systolic and diastolic dysfunction.