南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (03): 349-.

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双脉冲多普勒超声心动图技术测量TE-e’评估冠心病患者左心室舒张功能

汪晶晶，陈韵岱，王晶，智光，穆洋，徐勇   

  • 出版日期:2014-03-20 发布日期:2014-03-20

Evaluation of left ventricular diastolic function by TE-e’ measurement using dual Doppler
echocardiography in coronary heart disease patients with preserved systolic function

  • Online:2014-03-20 Published:2014-03-20

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摘要： 目的探讨双脉冲多普勒超声心动图技术测量舒张早期二尖瓣血流E波开始时间与舒张早期二尖瓣瓣环e’波开始时间差
值TE-e’，评估TE-e’诊断左心室舒张功能不全准确性。方法连续入组冠心病患者77例，所有患者均行冠脉造影，心导管测量左心
室舒张末压力（LVEDP）；双脉冲多普勒技术测量舒张早期二尖瓣血流峰值速度E与舒张早期二尖瓣瓣环峰值速度e’，计算E/e’
与TE-e’，评估左心室舒张末压力与TE-e’相关性及E/e’、TE-e’与TE-e’联合E/e’，诊断左心室舒张末功能不全［指左心室舒张末期压力
≥12 mmHg（1 mmHg=0.133 kPa）］的准确性。结果1、左心室舒张末压（LVEDP）与TE-e’，E/e’相关性分别为r=0.42和r=0.79，P<
0.001；2、TE-e’≥38 ms时，诊断左心室舒张功能不全的敏感性为54%，特异性为79%，ROC曲线下面积0.71。E/e’≥9.2时，诊断左
心室舒张功能不全敏感性为74%，特异性为81%，ROC曲线下面积0.87；3、联合E/e’≥9.2，TE-e’≥38 ms诊断左心室舒张功能不全敏
感性为100%，特异性为62%，ROC曲线下面积0.96。结论双脉冲多普勒技术测量TE-e’为评估左心室舒张功能不全的有效指
标，联合E/e’能够提高诊断左心室舒张功能不全的准确性。

Abstract: Objective To evaluate the accuracy of the time interval between the onset of early transmitral flow velocity (E) and
that of early diastolic mitral annular velocity (e’) (TE-e’) measured by dual Doppler echocardiography in the diagnosis of
diastolic dysfunction. Methods Seventy-seven coronary heart disease patients with preserved systolic function underwent a
echocardiographic study. Early transmitral flow velocity E and early diastolic mitral annular velocity e’ were simultaneously
recorded by dual Doppler echocardiography. The E/e’ and TE-e’ were calculated and compared with the left ventricular end
diastolic pressure (LVEDP), which was measured invasively. The validity of TE-e’, E/e’ and their combination was analyzed in
estimating left ventricular dysfunction (LVEDP ≥12 mmHg). Results The single-beat E/e’ and TE-e’ were correlated with the
LVEDP (r=0.79 and 0.42, respectively, P<0.001). Receiver-operating characteristic analysis showed that the optimal cut-off for
TE-e’ was 38 ms (sensitivity 54%, specificity 79%, AUC 0.71) and that for E/e’ was 9.2 (sensitivity 74%, specificity 81%, AUC 0.87)
for diagnosis of left ventricular diastolic dysfunction. The combined cut-offs of TE-e’ ≥38 ms and E/e’ ≥9.2 had a sensitivity of
100% and a specificity of 62% in diagnosing left ventricular diastolic dysfunction with an AUC of 0.96. Conclusion In patients
with coronary heart disease, the simultaneous recording of TE-e’ by dual Doppler echocardiography can accurately estimate
diastolic dysfunction, and its combination with E/e’ can further improve the diagnostic accuracy.