Differences of echocardiographic parameters in patients with chronic heart failure and preserved ejection fraction under different left ventricular end-diastolic pressures(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2021年第5期
- Page:
- 596-601
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Differences of echocardiographic parameters in patients with chronic heart failure and preserved ejection fraction under different left ventricular end-diastolic pressures
- Author(s):
- JIANG Dianhu1; CHEN Zhiwang2; BAI Shuchang3; MAO Xianyi1; LAI Juxia1; XIA Zhangqing3; CHEN Puwen3
- 1. Department of Medical Ultrasound, the Second Peoples Hospital of Foshan City, Foshan 528000, China 2. Department of Ultrasound, Traditional Chinese Medicine Hospital of Guixi City, Guixi 335400, China 3. Department of Cardiology, the Second Peoples Hospital of Foshan City, Foshan 528000, China
- Keywords:
- Keywords: left ventricular end-diastolic pressure chronic heart failure with preserved ejection fraction echocardiography
- PACS:
- R445.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2021.05.014
- Abstract:
- Abstract: Objective To study the changes of echocardiographic parameters in patients with chronic heart failure and preserved ejection fraction (HFpEF) under different left ventricular end-diastolic pressures (LVEDP), and to further explore the efficiency of different measurement methods in predicting LVEDP increase. Methods A total of 96 HFpEF patients admitted to hospital from July 2018 to April 2020 were enrolled in the study. All patients underwent left heart catheterization, and their LVEDP was measured at the end of diastole. According to LVEDP real-time measurements, the selected patients were divided into group A (35 cases, normal LVEDP, real-time measurements ≤15 mmHg) and group B (61 cases, increased LVEDP, real-time measurements >15 mmHg). The differences in echocardiographic parameters between two groups were compared. The echocardiographic parameters discussed in the study included left ventricular ejection fraction (LVEF), left atrial volume index (LAVI), the maximum velocity of tricuspid regurgitation (TRmax), the early diastolic blood flow velocity of mitral valve orifice (E)/the late diastolic blood flow velocity of mitral valve orifice (A), the deceleration time of peak E (DT), the duration of peak A (A-dur), pulmonary vein systolic S-wave velocity (PVs), early diastolic D-wave velocity (PVd), PVs/PVd, atrial systolic pulmonary vein retrograde A-wave velocity (PVa), the duration of atrial systolic pulmonary vein retrograde A-wave blood flow (PVa-dur), difference between the duration of atrial systolic pulmonary vein retrograde blood flow and the duration of mitral valve atrial systolic blood flow (PvaD-AD), the early diastolic average velocity of mitral valve ring (e), the early diastolic velocity of mitral valve ring side wall (elat), the early diastolic velocity of mitral valve ring spacing (esep), E/e and E/elat, E/esep. The echocardiographic parameters with statistical significance were divided into LAVI, spectral Doppler-related parameters (TRmax, PVa, Pva-dur, PvaD-AD,) and tissue Doppler-related parameters (e, elat，esep, E/e, E/elat, E/esep) according to different measurement methods. Receiver operating characteristic curve was used to compare and analyze the efficiency of 3 groups of parameters in independently predicting LVEDP increase, and further compare and analyze the sensitivity and specificity of LAVI combined with spectral Doppler-related parameters or tissue Doppler-related parameters in predicting LVEDP increase. Results The LAVI, TRmax, PVa, Pva-dur, PvaD-AD, E/e, E/elat, E/esep in group A were significantly lower than those in group B (P<0.05), while e, elat and esep were significantly higher than those in group B (P<0.05), but no statistical difference was found in LVEF, E/A, DT, A-dur, PVs, PVd, PVs/PVd (P>0.05). The receiver operating characteristic curve analysis showed that the most effective predictor of LVEDP increase was spectrum Doppler-related parameters (TRmax, PVa, Pva-dur, PvaD-AD), followed by tissue Doppler-related parameters (e, elat, esep, E/e, E/elat, E/esep) and LAVI. The combination of LAVI and spectrum Doppler-related parameters has a higher diagnostic efficiency than LAVI combined with tissue Doppler-related parameters in predicting LVEDP increase. Conclusion The comprehensive application of echocardiographic parameters has a certain predictive effect on the increase of LVEDP.
Last Update: 2021-05-31