Online Journal
IF値: 0.677(2017年)→0.966(2018年)


Journal of Medical Ultrasonics

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2007 - Vol.34

Vol.34 No.03

Rapid Communication(速報)

(0355 - 0358)


Left atrial volume index is useful for predicting increased pulmonary artery wedge pressure in coronary heart disease patients with mildly elevated E/E’

松浦 秀哲1, 山田 晶2, 高橋 礼子1, 杉本 恵子1, 石川 隆志1, 岩瀬 正嗣3, 菱田 仁2, 大島 久二1

Hideaki MATSUURA1, Akira YAMADA2, Ayako TAKAHASHI1, Keiko SUGIMOTO1, Takashi ISHIKAWA1, Masatsugu IWASE3, Hitoshi HISHIDA2, Hisaji OHSHIMA1

1藤田保健衛生大学病院臨床検査部, 2藤田保健衛生大学医学部循環器内科, 3藤田保健衛生大学短期大学医療情報技術学科

1Fujita Health University Hospital, Clinical Laboratory, 2Division of Cardiology, Fujita Health University, 3Department of Medical Information Technology in Junior College, Fujita Health University

キーワード : left atrial volume index, E/E’, pulmonary artery wedge pressure, coronary heart disease


Background: The ratio of early transmitral velocity to early diastolic velocity of the mitral annulus (E/E’) has been shown to be an excellent predictor of left ventricular filling pressure. However, the clinical significance of mildly elevated E/E’ (8≤E/E’≤15) remains to be clarified. Left atrial (LA) volume would reflect the duration and severity of left ventricular diastolic dysfunction. There is a graded relation between LA volume index (LAVI) and severity of diastolic dysfunction. Purpose: We hypothesized that LAVI could be useful for predicting increased PAWP in coronary heart disease patients with mildly elevated E/E’. Subjects and Methods: Patients admitted to the coronary care unit at our hospital who had indwelling pulmonary artery catheters were eligible. Fifty-eight patients without atrial fibrillation or severe mitral regurgitation underwent echocardiography (Sonos 5500 or 7500; S3 probe; Philips). Tissue Doppler imaging of the mitral annulus was also obtained. Early diastolic E’ velocity was measured from the septal mitral annulus velocity profile in the apical 4-chamber view. LA volume was assessed by the biplane Simpson’s method from apical 4- and 2-chamber views in end systole. LAVI was obtained by correcting for body surface area. PAWP was measured simultaneously in all the patients. Results: In 23 patients with mildly elevated E/E’ (8≤E/E’≤15) , there was no correlation between PAWP and E/E’ (p=0.40). However, LAVI positively correlated with PAWP in those patients (r=0.64, p<0.001). LAVI≥32ml/m2 was the optimal cutoff to predict PAWP≥15mmHg (sensitivity 72%, specificity 80%). Conclusion: LAVI could be a useful adjunct measure for predicting increased PAWP in coronary heart disease patients with mildly elevated E/E’.