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ID 116987
Title Alternative
心収縮予備能に対する心房細動カテーテルアブレーションの効果 : 下肢陽圧負荷心エコー図法を用いた検討
Coronary Artery Disease/Effects of Ablation on Cardiac Reserve
Author
Ishii, Nao Tokushima University
Shono, Ayu Kobe University
Matsumoto, Kensuke Kobe University
Nishio, Susumu Tokushima University
Yamaguchi, Natsumi Tokushima University
Hirata, Yukina Tokushima University
Keywords
Echocardiography
Preload Stress
atrial fibrillation
Cardiac Reserve
left atrial function
Content Type
Thesis or Dissertation
Description
The effects of catheter ablation on exercise tolerance and quality of life in patients with atrial fibrillation (AF) have been reported. We assessed cardiac function in more detail using the leg positive pressure (LPP) technique and found that contractile reserve is particularly important in relation to exercise tolerance and prognosis. In this study, we used the LPP technique to examine changes in contractile reserve immediately after ablation and 6 months later. We prospectively enrolled patients who underwent catheter ablation for AF at 2 institutes. We performed LPP stress echocardiography 2 to 3 days after (FU-1) and 6 months after (FU-2) ablation to examine changes in cardiac function indexes. The primary end point was improvement in contractile reserve. Ultimately, 109 patients (mean age 67.4 ± 9.6 years; 70% men) underwent 2 sessions of LPP stress echocardiography. The median CHA2DS2-VASC score was 2 (interquartile range 13). From FU-1 to FU-2, the change in the stroke volume index after the LPP maneuver increased in patients with paroxysmal and persistent AF with low CHA2DS2-VASC scores (both p <0.05). Regardless of AF subtype, contractile reserve at FU-2 improved in patients with low CHA2DS2-VASC scores compared with that at FU-1. In contrast, patients with high CHA2DS2-VASC scores had no change. In conclusion, patients with AF with a low CHA2DS2-VASC score had improved contractile reserve after ablation, whereas patients with high scores did not show any improvement. Aggressive interventions in patients with high scores may lead to better management after catheter ablation.
Journal Title
The American Journal of Cardiology
ISSN
00029149
NCID
AA00048410
AA11522841
Publisher
Elsevier
Volume
168
Start Page
71
End Page
77
Published Date
2022-01-19
Remark
内容要旨・審査要旨・論文本文の公開
本論文は,著者Nao Ishii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3597号
Diploma Number
甲医第1527号
Granted Date
2022-03-23
Degree Name
Doctor of Medical Science
Grantor
Tokushima University
departments
University Hospital
Medical Sciences