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目的探讨二尖瓣舒张早期血流速度(E)与二尖瓣环舒张早期运动速度(E′)之比(E/E′)对非瓣膜病心房纤颤患者心脏功能进行早期准确评估的可行性及其与血浆脑钠肽水平的相关性。方法将478例非瓣膜病心房纤颤患者按有无心力衰竭症状分为NYHAⅠ级组94例、NYHAⅡ级组144例、NYHAⅢ级组128例及NYHAⅣ级组112例,比较4组患者的临床资料及超声心动图参数,并分析各参数与血浆脑钠肽水平相关性。结果与NYHAⅠ级组和NYHAⅡ级组比较,NYHAⅢ级组和NYHAⅣ级组E/E′、左房收缩末期内径、左房收缩末期面积及血浆脑钠肽水平均增加(均P<0.05),左室射血分数下降(P<0.05)。随着心房纤颤患者心力衰竭症状的加重,E/E′逐渐增加,与NYHA分级相一致。左房收缩末期内径、左房收缩末期面积及E/E′均与血浆脑钠肽水平呈正相关,与左室射血分数呈负相关。与左房收缩末期内径、左房收缩末期面积及左室射血分数比较,E/E′与血浆脑钠肽水平相关性最强(r=0.701,P<0.01)。结论 E/E′值是心房纤颤患者心力衰竭进程中评估心脏功能状态的可靠指标。
Objective To investigate the early and accurate assessment of cardiac function in patients with nonvalvular atrial fibrillation at early mitral valve diastolic velocity (E) and mitral annular early diastolic velocity (E ’) ratio (E / E’) Sexuality and Its Relationship with Plasma Brain Natriuretic Peptide. Methods 478 patients with non-valvular atrial fibrillation were divided into NYHA class Ⅰ group (n = 94), NYHA Ⅱ group (n = 144), NYHAⅢ class group (n = 128) and NYHA Ⅳ class group And echocardiographic parameters, and analyze the correlation between each parameter and plasma brain natriuretic peptide. Results Compared with NYHAⅠgroup and NYHAⅡgroup, EHA, NYHAⅢgroup, NYHA Ⅳ group, end-systolic left atrial diameter, atrial end-systolic area, and plasma BNP level were increased (all P <0.05) Room ejection fraction decreased (P <0.05). With the aggravation of heart failure symptoms in patients with atrial fibrillation, E / E ’gradually increased, consistent with NYHA classification. Left atrial end-systolic diameter, left atrial end-systolic area, and E / E ’were positively correlated with plasma BNP levels and negatively correlated with left ventricular ejection fraction. E / E ’had the highest correlation with plasma brain natriuretic peptide (r = 0.701, P <0.01) compared with the end-systolic diameter of left atrium, the area of left atrial systolic and the left ventricular ejection fraction. Conclusions The E / E ’value is a reliable indicator of heart function in patients with atrial fibrillation during heart failure.