Diagnosis Value Of Left Atrial Volume Index For Diastolic Heart Failure And The Correlation With E/E'

Objective: In this study,we probe the value of the echocardiographic indicators–Left Atrial Volume Index in the diagnosis of diastolic heart failure. As the tissue Doppler parameter E/E' has a high-value in reflecting Left ventricular filling pressure, we further analyze the relation between LAVI and E/E ' to provide a new diagnostic index for diastolic heart failure.Methods: 30 patients who were diagnosed by the diagnostic process of European Society of Cardiology 2007 for diastolic heart failure were enrolled.Patients with Rheumatic heart disease, heart valve diseases(especially more than mild mitral regurgitation), congenital heart disease, pericardial disease,chronic obstructive pulmonary disease,poor image quality of echocardiography,and patients with serious liver and kidney dysfunction were ruled out.31 patients were collected in control group,which were get rid of systolic and diastolic heart failure,including normal and complicated with hypertension, diabetes and other underlying diseases in patients, exclusion criteria with the patient group. We routinely measure and calculate the body surface area, B-type natriuretic peptide, echocardiography measurements of the indicators - left ventricular end-diastolic volume (LVEDV) , left ventricular diastolic end systolic volume (LVESV) , left ventricular ejection fraction (LVEF),fractional shortening (FS), interventricular septum diameter (IVSd), left ventricular posterior wall diameter (LVPWd),the ratio of mitral early diastolic and late diastolic peak blood flow ratio (E/A),and the ratio of mitral early diastolic blood flow peak and mitral annulus velocity (E/E') and left atrial volume index (LAVI). We analyze the relation between the LAVI and left ventricular filling pressure by Doppler tissue imaging parameters E/E '.The diagnostic criteria is based on The 2007 European Society of Cardiology diastolic heart failure diagnostic process, a new ultrasound index - left atrial volume index as a diagnostic test, We compared measurement data with carried out blindly, simultaneous comparison, calculate the diagnostic sensitivity, specificity and correct diagnostic index, drawing receiver operating curve (ROC curve) in order to better evaluate the diagnostic value of diagnostic tests. Results:1,There was no significant differences in age and gender between Control group and patient group (P > 0.05).There was no significant differences in LVEDd,LVESd,LVEDV,LVESV,IVSd,LVPWd between the two groups (P > 0.05), but there was a significant difference in LAVI(P<0.01).2,There is a good correlation between LAVI与E/E'(r = 0.814, P <0.01). It is a reliable indicator on reflecting left ventricular filling pressure,to some extent LAVI can be estimated left ventricular filling pressure, and further reflects the left ventricular diastolic function.3,This study applied the the LAVI value American Association of Echocardiography guidelines recommend to all patients. Adopt LAVI>29ml/m2 as the critical point ,the sensitivity of the diagnostic tests obtained 0.93, specificity 0.81, positive predictive value 0.82, negative predictive value 0.93; Adopt LAVI>40ml/m2 as the critical point, the sensitivity of the diagnostic test obtained 0.73, specificity 0.97, positive predictive value 0.96, negative predictive value 0.79.4,The ROC area under the curve close to 1 (AUGROC = 0.954,) in diagnosis of diastolic heart failure in LAVI which was considered that the diagnosis has a high fidelity, better prospects in the clinical application。5,In this experiment, the diagnosis of diastolic heart failure LAVI ideal critical point is -34ml/m2 by the correct diagnosis index (Youden Index).Conclusion:1. There was a difference between diastolic heart failure patients and normal patients in LAVI,and it has a good correlation to E/E',to some extent it can be estimated to left ventricular filling pressure, and it can be used as diagnostic indicators.2. In the case of LAVI<29ml/m2, the negative predictive value for the diagnosis of Diastolic Heart Failure is high, which can be used to rule out a diagnosis. In the case of LAVI>40ml/m2, the positive predictive value is high, which can be used to clarify a diagnosis.3. Both the sensitivity and specificity of LAVI in diagnosing diastolic heart failure are high. The ROC area under the curve is nearly 1, with a high diagnosis value in diastolic heart failure. 4. By this study, we proposed that the diagnosis of diastolic heart failure in LAVI ideal critical point is -34ml/m2.