超声心动图及B型脑钠肽与左心室舒张期压力的相关性及受试者工作特征曲线评价

目的应用受试者工作特征（ROC）曲线分析左心室舒张末期压力（LVEDP）及舒张早期经二尖瓣口血流速度与舒张早期二尖瓣环的运动速度比值（E/Ea）、B型脑钠肽（BNP）的关系。方法收集疑有冠心病行选择性冠状动脉造影检查104例患者进行LVEDP测定,并行多普勒超声心动图检查和BNP测定。分析上述指标的相关性及ROC曲线特征。根据美国纽约心脏病协会（NYHA）的标准对心脏的患者进行心功能分级。结果 104例患者中,86例有器质性心脏病（心功能Ⅰ级及Ⅱ级各18例,心功能Ⅲ级21例,心功能Ⅳ级29例）,另18例无明显的心脏病证据。随着心功能分级的增加,LVEDP、BNP及E/Ea比值呈不同程度进行性的恶化。LVEDP与BNP和E/Ea呈正相关（r=0.786,0.651,均P〈0.01）,与E/A和Ea/Aa呈负相关（r=-0.231,-0.652,P〈0.05或〈0.01）。E/Ea及BNP的ROC曲线下面积分别为0.830及0.951（均P〈0.01）。结论 E/Ea比值及BNP能较好地无创性评估LVEDP,但BNP的准确度更高。

Combining echocardiography and B-type natriuretic peptide in evaluation of left ventricular filling pressures with receiver-operating characteristic(ROC) analysis

Objective To explore the relation between left ventricular end-diastolic pressure(LVEDP) with the ratio of transmitral early diastolic velocity/mitral annular early diastolic velocity(E/Ea ratio) and B-type natriuretic peptide(BNP) by receiver-operating characteristic(ROC) analysis.Methods One-hundred and four patients who were suspected coronary artery disease experienced selected artery angiography,and LVEDP was measured meanwhile.They underwent a thorough Doppler-echocardiographic and pulsed tissue-Doppl...