PDF(Sci-hub)
Abstract：
BACKGROUND: The E/e\' index measured in spectral tissue Doppler is included in the recommendations for the diagnosis by transthoracic Doppler echocardiography of left ventricular diastolic dysfunction and heart failure with preserved ejection fraction. While E/e\' is influenced by age in healthy individuals, no studies have evaluated this index in elderly patients. This study addressed the clinical relevance of E/e\' in assessment of left ventricular diastolic function in elderly patients with preserved ejection fraction and its relevance from both a diagnostic and prognostic perspective based on the existing literature.
METHODS: A total of 76 patients≥70years of age were prospectively included. The analysis of left ventricular diastolic function was adapted from the 2016 ASE/EACVI recommendations without consideration of E/e\'.
RESULTS: The mean age was 85years. In all, 42 patients had moderate-to-severe diastolic dysfunction (elevated left atrial pressure). Mean E/e\' was significantly correlated with diastolic function (r=0.58, P<0.001). Mean E/e\'>13.3 had a sensitivity of 86% and a specificity of 91% in the diagnosis of moderate-to-severe diastolic dysfunction (AUC: 0.92). E/(e\'xs\') (AUC: 0.89) and NT pro-BNP (AUC: 0.80) did not perform better than E/e\'. The existing literature offers large body of evidence that E/e\' provides essential diagnostic and prognostic information in older patients with cardiovascular disease.
CONCLUSIONS: E/e\' is accurate in the diagnosis of significant diastolic dysfunction, in the diagnosis of heart failure with preserved ejection fraction and in risk stratification in older patients with cardiovascular disease.
METHODS: A total of 76 patients≥70years of age were prospectively included. The analysis of left ventricular diastolic function was adapted from the 2016 ASE/EACVI recommendations without consideration of E/e\'.
RESULTS: The mean age was 85years. In all, 42 patients had moderate-to-severe diastolic dysfunction (elevated left atrial pressure). Mean E/e\' was significantly correlated with diastolic function (r=0.58, P<0.001). Mean E/e\'>13.3 had a sensitivity of 86% and a specificity of 91% in the diagnosis of moderate-to-severe diastolic dysfunction (AUC: 0.92). E/(e\'xs\') (AUC: 0.89) and NT pro-BNP (AUC: 0.80) did not perform better than E/e\'. The existing literature offers large body of evidence that E/e\' provides essential diagnostic and prognostic information in older patients with cardiovascular disease.
CONCLUSIONS: E/e\' is accurate in the diagnosis of significant diastolic dysfunction, in the diagnosis of heart failure with preserved ejection fraction and in risk stratification in older patients with cardiovascular disease.
摘要：
背景：通过经胸多普勒超声心动图诊断左心室舒张功能障碍和射血分数保留的心力衰竭的建议包括在频谱组织多普勒测量的E/e指数中。虽然健康个体的E/E受年龄的影响，尚无研究在老年患者中评估该指数.本研究基于现有文献，从诊断和预后的角度探讨了E/e'在评估射血分数保留的老年患者左心室舒张功能中的临床相关性。
方法：前瞻性纳入76例年龄≥70岁的患者。左心室舒张功能的分析根据2016年ASE/EACVI建议进行调整，不考虑E/e'。
结果：平均年龄为85岁。总之,42例患者有中度至重度舒张功能障碍（左心房压升高）。平均E/e与舒张功能显著相关(r=0.58,P<0.001)。平均E/e'>13.3在诊断中度至重度舒张功能障碍中的敏感性为86％，特异性为91％（AUC：0.92）。E/(e\'xs\')(AUC:0.89)和NTpro-BNP(AUC:0.80)的表现不优于E/e\'。现有文献提供了大量证据，证明E/e'为老年心血管疾病患者提供了必要的诊断和预后信息。
结论：E/e'在诊断显著的舒张功能障碍方面是准确的，用于诊断射血分数保留的心力衰竭和老年心血管疾病患者的风险分层。
方法：前瞻性纳入76例年龄≥70岁的患者。左心室舒张功能的分析根据2016年ASE/EACVI建议进行调整，不考虑E/e'。
结果：平均年龄为85岁。总之,42例患者有中度至重度舒张功能障碍（左心房压升高）。平均E/e与舒张功能显著相关(r=0.58,P<0.001)。平均E/e'>13.3在诊断中度至重度舒张功能障碍中的敏感性为86％，特异性为91％（AUC：0.92）。E/(e\'xs\')(AUC:0.89)和NTpro-BNP(AUC:0.80)的表现不优于E/e\'。现有文献提供了大量证据，证明E/e'为老年心血管疾病患者提供了必要的诊断和预后信息。
结论：E/e'在诊断显著的舒张功能障碍方面是准确的，用于诊断射血分数保留的心力衰竭和老年心血管疾病患者的风险分层。
