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タイトル: | Association of the low e’ and high E/e’ with long-term outcomes in patients with normal ejection fraction |
著者: | Seko, Yuta Kato, Takao ![]() ![]() ![]() Shiba, Masayuki Morita, Yusuke Yamaji, Yuhei Haruna, Yoshizumi Nakane, Eisaku Hayashi, Hideyuki Haruna, Tetsuya Inoko, Moriaki |
著者名の別形: | 加藤, 貴雄 |
発行日: | Nov-2019 |
出版者: | BMJ |
誌名: | BMJ Open |
巻: | 9 |
号: | 11 |
論文番号: | e032663 |
抄録: | Objective We aimed to evaluate the association of the severity of left ventricular (LV) diastolic dysfunction with long-term outcomes in patients with normal ejection fraction. Design Retrospective study. Setting A single centre in Japan. Participants We included 3576 patients who underwent both scheduled transthoracic echocardiography and ECG between 1 January and 31 December 2013, in a hospital-based population after excluding valvular diseases or low ejection fraction (<50%) or atrial fibrillation and categorised them into three groups: septal tissue Doppler early diastolic mitral annular velocity (e′)≥7 (without relaxation disorder, n=1593), e′<7 and early mitral inflow velocity (E)/e′≤14 (with relaxation disorder and normal LV end-diastolic pressure, n=1337) and e′<7 and E/e′>14 (with relaxation disorder and high LV end-diastolic pressure, n=646). Primary and secondary outcome measures The primary outcome measure was a composite of all-cause death and major adverse cardiac events (MACE). The secondary outcome measure were all-cause death and MACE, separately. Results The cumulative 3-year incidences of the primary outcome measures were significantly higher in the e′<7 and E/e′≤14 (19.0%) and e′<7 and E/e′>14 group (23.4%) than those for the e′≥7 group (13.0%; p<0.001). After adjusting for confounders, the excess 3-year risk of primary outcome for the groups with e′<7 and E/e′≤14 related to e′≥7 (HR: 1.24; 95% CI 1.02 to 1.52) and e′<7 and E/e′>14 related to e′<7 (HR: 1.57; 95% CI 1.28 to 1.94) were significant. The severity of diastolic dysfunction was associated with incrementally higher risk for primary outcomes (p<0.001). Conclusion The severity of LV diastolic dysfunction using e′<7 and E/e′>14 was associated with the long-term prognosis in patients with normal ejection fraction in an incremental fashion. |
著作権等: | © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
URI: | http://hdl.handle.net/2433/244827 |
DOI(出版社版): | 10.1136/bmjopen-2019-032663 |
PubMed ID: | 31753896 |
出現コレクション: | 学術雑誌掲載論文等 |
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