ID | 114193 |
Title Alternative | 更新された左室拡張機能評価勧告と心不全入院患者における心血管イベント
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Author |
Torii, Yuta
Tokushima University
Kusunose, Kenya
Tokushima University
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Yamada, Hirotsugu
Tokushima University
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Nishio, Susumu
Tokushima University
Hirata, Yukina
Tokushima University
Amano, Rie
Tokushima University
Yamao, Masami
Tokushima University
Zheng, Robert
Tokushima University
Saijo, Yoshihito
Tokushima University
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Yamada, Nao
Tokushima University
Ise, Takayuki
Tokushima University
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Yamaguchi, Koji
Tokushima University
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Yagi, Shusuke
Tokushima University
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Soeki, Takeshi
Tokushima University
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Wakatsuki, Tetsuzo
Tokushima University
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Sata, Masataka
Tokushima University
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Keywords | Diastolic dysfunction
Echocardiography
Left atrial pressure
Readmission risk
Cardiovascular event
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Content Type |
Thesis or Dissertation
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Description | Background: Evaluation of diastolic dysfunction is crucial in determining elevated left atrial pressure. However, a validation of the long-term prognostic value of the newly proposed algorithm updated in 2016 has not been performed. The aim of the present study was to investigate the relative value of the updated 2016 diastolic dysfunction grading system for the incidence of readmission in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
Methods: Two hundred thirty-two patients hospitalized with HF were retrospectively evaluated. Subjects were divided into two subgroups: those with HFrEF (n = 127) and those with HFpEF (n = 105). Readmission risk scores were calculated using the Yale Center for Outcomes Research and Evaluation HF, LACE index, and HOSPITAL scores. The primary end point was readmission following HF and cardiac death. Results: Over a period of 24 months, 86 patients were either readmitted or died. Multivariate Cox analysis was performed on both the HFrEF and HFpEF groups. In the HFrEF group, both the 2009 and 2016 algorithms had superior incremental value for the association of the primary end point to several readmission risk scores. In the HFpEF group, only the 2016 algorithm led to significant improvement in association with the primary end point. The 2016 algorithm had incremental value over several readmission risk scores alone. Conclusions: The recommendations of the 2016 algorithm can be useful for readmission and cardiac mortality risk assessment in patients with HFrEF and HFpEF. The use of echocardiography to estimate elevated left atrial pressure appears to identify a higher risk group and may allow a more tailored approach to therapy. |
Journal Title |
Journal of the American Society of Echocardiography
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ISSN | 08947317
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NCID | AA10709494
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Publisher | The American Society of Echocardiography|Elsevier
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Volume | 32
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Issue | 10
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Start Page | 1286
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End Page | 1297.e2
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Published Date | 2019-08-01
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Remark | 内容要旨・審査要旨・論文本文の公開
本論文は, 著者Yuta Toriiの学位論文として提出され, 学位審査・授与の対象となっている。 |
EDB ID | |
DOI (Published Version) | |
URL ( Publisher's Version ) | |
FullText File | |
language |
eng
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TextVersion |
ETD
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MEXT report number | 甲第3355号
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Diploma Number | 甲医第1438号
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Granted Date | 2020-03-23
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Degree Name |
Doctor of Medical Science
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Grantor |
Tokushima University
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departments |
University Hospital
Medical Sciences
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