title: [Diagnostic values of mitral inflow and mitral annulus diastolic velocity for heart failure with preserved ejection fraction].
abstract: OBJECTIVE
  To explore the diagnostic values of ratios of early diastolic peak transmitral velocity(E) to late velocity(A) (E/A) and E to early diastolic peak mitral annulus velocity (E/E') for heart failure patients with preserved ejection fraction (HF-PEF).
  
  
  METHODS
  Two hundred and sixteen healthy people were divided into <50 years, 50-59 years, 60-69 years, and ≥70 years groups to clarify the impact of aging on E/A and E/E'. Two hundred and two newly diagnosed consecutive in-patients with HF-PEF and 221 age- and sex-matched non-heart-failure subjects with risk factors of HF-PEF (negative controls) were enrolled.The diagnostic values and cutoff points of E/A and E/E' for HF-PEF were derived from receiver operating characteristic curve (ROC) analysis.
  
  
  RESULTS
  E/A and E/E' were significantly different among age groups in healthy controls (all P<0.01). Compared with <50 years group, average E/A was lower and average E/E' was higher in ≥70 years group(both P<0.01). E/A ratio was less than 1 in 68%(71/105), E/E' was >8 cm/s in 48% (50/105)healthy people with age≥60 years. Neither E/A nor E/E' of HF-PEF patients was statistically different regarding to NYHA classification (grade Ⅱ, Ⅲ, Ⅳ), but NT-proBNP value increased in proportion to higher NYHA classification(P<0.01). The area of E/E' under ROC for diagnosing HF-PEF was 0.839(P<0.01), and the corresponding cutoff point was 9.5 with a sensitivity of 86% and a specificity of 69%. The areas of E/A (larger value or smaller value indicating positive) under ROC for diagnosing HF-PEF were 0.469 and 0.531, respectively(all P>0.05).
  
  
  CONCLUSIONS
  Aging exerts significant impacts on both E/A and E/E'. E/E' has moderate diagnostic accuracy while E/A is of limited value for diagnosing HF-PEF.
authors.affiliation: Department of Geriatric Cardiology, First Hospital of Lanzhou University, Lanzhou 730000, China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Liu
authors.forename: S M
authors.initials: SM
authors.lastname: Ma
authors.forename: L
authors.initials: L
authors.lastname: Yang
authors.forename: L L
authors.initials: LL
authors.lastname: Xue
authors.forename: C D
authors.initials: CD
authors.lastname: Qiao
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: Y Y
authors.initials: YY
authors.lastname: Liu
authors.forename: J G
authors.initials: JG
authors.lastname: Yang
mesh_terms: D000368:Aged; D003971:Diastole; D006333:Heart Failure; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain