Background: This study aimed to investigate the correlation between the ratio of diastolic to systolic durations (D/S) and echocardiographic parameters of patients with chronic heart failure (CHF) and evaluate whether the D/S can be used as a supplementary biomarker for the classification of heart failure (HF) phenotypes.
Methods: In total, 122 CHF patients with a left ventricular ejection fraction (LVEF) < 40%, 40%≤LVEF< 50%, or ≥ 50% were categorized as having HF with a reduced ejection fraction (HFrEF) (N=32), HF with a mid-range ejection fraction (HFmrEF) (N=21) or HF with a preserved ejection fraction (HFpEF) (N=69), respectively. All patients underwent echocardiography for assessment of nineteen structural and functional echocardiographic parameters and digital phonocardiography for the measurement of D/S. Spearman correlation was used to analyse the associations between the D/S and echocardiographic parameters. Multivariate logistic regression analysis was performed to examine the associations between the D/S and HF phenotypes, and receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive value of the D/S in the classification of HF phenotypes.
Results: The D/S values of patients with HFrEF, HFmrEF and HFpEF were 1.32± 0.06, 1.44± 0.11 and 1.54± 0.08, respectively, which were significantly different (All P< 0.05). A close correlation between the D/S and LVEF was found (r=0.777, P< 0.001). The multivariate analysis indicated that the D/S was an independent risk factor for CHF phenotypes (OR=4.927, 95% CI 2.532– 9.587; P< 0.001). The area under the ROC curve for distinguishing between HFmrEF and HFpEF using the D/S was 0.764 (95% CI 0.707– 0.845; P < 0.001) and that for distinguishing between HFmrEF and HFrEF using the D/S was 0.821 (95% CI 0.755– 0.882; P < 0.001).
Conclusion: The D/S was significantly associated with LVEF, and as LVEF decreased, the D/S tended to decrease, which could also serve as a noninvasive supplementary indicator for detecting systolic and diastolic dysfunction.



中文翻译：

---

舒张期与收缩期比值与超声心动图测量的相关性研究及其在心力衰竭表型分类中的应用

背景：本研究旨在探讨慢性心力衰竭（CHF）患者舒张期与收缩期比值（D/S）与超声心动图参数之间的相关性，并评估 D/S 是否可以作为心脏衰竭的补充生物标志物。心力衰竭 (HF) 表型的分类。
方法：总共有 122 名左心室射血分数 (LVEF) < 40%、40%≤LVEF< 50% 或 ≥ 50% 的 CHF 患者被归类为射血分数降低的心衰 (HFrEF) (N=32)，分别具有中等射血分数 (HFmrEF) (N=21) 或射血分数保留 (HFpEF) (N=69) 的 HF。所有患者都接受了超声心动图评估 19 项结构和功能超声心动图参数和数字超声心动图测量 D/S。Spearman 相关性用于分析 D/S 和超声心动图参数之间的关联。进行多变量逻辑回归分析以检查 D/S 和 HF 表型之间的关联，
结果： HFrEF、HFmrEF和HFpEF患者的D/S值分别为1.32±0.06、1.44±0.11和1.54±0.08，差异有统计学意义（均P<0.05）。发现 D/S 和 LVEF 之间存在密切相关性（r=0.777，P<0.001）。多变量分析表明，D/S 是 CHF 表型的独立危险因素（OR=4.927, 95% CI 2.532–9.587；P<0.001）。使用 D/S 区分 HFmrEF 和 HFpEF 的 ROC 曲线下面积为 0.764（95% CI 0.707–0.845；P < 0.001），使用 D/S 区分 HFmrEF 和 HFrEF 的 ROC 曲线下面积为 0.821（95% CI 0.755–0.882；P < 0.001)。
结论：D/S与LVEF显着相关，随着LVEF下降，D/S趋于下降，也可以作为检测收缩和舒张功能障碍的无创补充指标。