E／Ea对左心室射血分数正常的心力衰竭患者的诊断意义

目的分析左心室射血分数正常的心力衰竭（heartfailurewithnormalejectionfraction，HFNEF）患者的临床特点及E／Ea指数对其的诊断意义。方法将100例心力衰竭患者分为HFNEF组53例和射血分数降低的心力衰竭（heartfailurewithreducedejectionfraction，HFREF）组47例，并选择同期健康体检者50名作为对照组。比较各组临床特征及左心室功能指标的差异。结果（1）HFNEF组患者女性患者比例明显多于HFREF组，差异有统计学意义58．5％（31／53）US．42．5％（20／47），P〈0．05]；HFNEF组高血压性心脏病患者比例高于HFREF组64．2％（34／53）US．31．9％（15／47），P〈0．05]，而HFREF组冠状动脉粥样硬化性心脏病（冠心病）患者比例高于HFNEF组，差异有统计学意义44．7％（21／47）US．26．4％（14／53），P〈0．05]。（2）正常对照组、HFNEF组、HFREF组的心室收缩期速度峰值（sm）依次下降，心脏功能舒张期Ea依次减低，E／Ea指数依次升高。（3）患者心室收缩期速度峰值Sm值与血浆脑钠肽浓度呈线性负相关关系（r=-0．29，P〈0．05），E／Ea指数与血浆脑钠肽浓度呈正相关关系（r=O．617，P〈0．05）。结论E／Ea值是早期监测HFNEF患者心脏功能衰竭的重要指标。

Diagnostic significance of E/Ea in patients with heart failure with normal ejection fraction

Objectives To investigate the clinical characteristics in patients with heart failure with normal ejection fraction(HFNEF),and to analyze the diagnostic significance of E/Ea index for HFNEF.Methods One-hundred patients with heart failure were divided into two groups: HFNEF group(n=53) and heart failure with reduced ejection fraction(HFREF) group(n=47).There were another 50 healthy subjects served as control group.Clinical features and indexes of left ventricular function were compared among the three groups.Results(1) Compared with HFREF group,HFNEF group included significantly more females 58.5%(31/53) vs.42.5%(20/47),P<0.05].Ratio of hypertensive heart disease in HFNEF group was significantly higher than that in HFREF group 64.2%(34/53) vs.31.9%(15/47),P<0.05],and ratio of coronary heart disease in HFREF group was significantly higher than that in HFNEF group 44.7%(21/47) vs.26.4%(14/53),P<0.05].(2) Indexes of ventricular systolic peak velocity(Sm) and Ea decreased gradually from control group,HFNEF group to HFREF group,while the ratios of E/Ea increased gradually.(3) Plasma brain natriuretic peptide concentration was negatively correlated with index of Sm(r=-0.29,P<0.05) and positively correlated with index of E/Ea(r=0.617,P<0.05).Conclusions Ratio of E/Ea is an important index for early monitoring patients with HFNEF.