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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
Author
Torii, Yuta Tokushima University
Nishio, Susumu Tokushima University
Hirata, Yukina Tokushima University
Amano, Rie Tokushima University
Yamao, Masami Tokushima University
Zheng, Robert Tokushima University
Saijo, Yoshihito Tokushima University
Yamada, Nao Tokushima University
Keywords
Diastolic dysfunction
Echocardiography
Left atrial pressure
Readmission risk
Cardiovascular event
Content Type
Thesis or Dissertation
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
ISSN
08947317
NCID
AA10709494
Publisher
The American Society of Echocardiography|Elsevier
Volume
32
Issue
10
Start Page
1286
End Page
1297.e2
Published Date
2019-08-01
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
TextVersion
ETD
MEXT report number
甲第3355号
Diploma Number
甲医第1438号
Granted Date
2020-03-23
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences