ダウンロード数: 94
このアイテムのファイル:
ファイル | 記述 | サイズ | フォーマット | |
---|---|---|---|---|
j.jcin.2019.09.015.pdf | 1.86 MB | Adobe PDF | 見る/開く |
タイトル: | Decline in Left Ventricular Ejection Fraction during Follow-up in Patients with Severe Aortic Stenosis |
著者: | Minamino-Muta, Eri Kato, Takao https://orcid.org/0000-0001-8213-7999 (unconfirmed) Morimoto, Takeshi Taniguchi, Tomohiko Izumi, Chisato Nakatsuma, Kenji Inoko, Moriaki Shirai, Shinichi Kanamori, Norio Murata, Koichiro Kitai, Takeshi Kawase, Yuichi Miyake, Makoto Mitsuoka, Hirokazu Hirano, Yutaka Sasa, Tomoki Nagao, Kazuya Inada, Tsukasa Nishikawa, Ryusuke Takeuchi, Yasuyo Matsuda, Shintaro Yamane, Keiichiro Su, Kanae Komasa, Akihiro Ishii, Katsuhisa Kato, Yoshihiro Takabayashi, Kensuke Watanabe, Shin Saito, Naritatsu Minatoya, Kenji Kimura, Takeshi |
著者名の別形: | 加藤, 貴雄 齋藤, 成達 湊谷, 謙司 木村, 剛 |
キーワード: | conservative treatment left ventricular ejection fraction severe aortic stenosis |
発行日: | 23-Dec-2019 |
出版者: | Elsevier BV |
誌名: | JACC: Cardiovascular Interventions |
巻: | 12 |
号: | 24 |
開始ページ: | 2499 |
終了ページ: | 2511 |
抄録: | Objectives: The aim of this study was to investigate the prognostic impact of the decline in left ventricular ejection fraction (LVEF) at 1-year follow-up in patients with severe aortic stenosis (AS) managed conservatively. Background: No previous study has explored the association between LVEF decline during follow-up and clinical outcomes in patients with severe AS. Methods: Among 3, 815 patients with severe AS enrolled in the multicenter CURRENT AS (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis) registry in Japan, 839 conservatively managed patients who underwent echocardiography at 1-year follow-up were analyzed. The primary outcome measure was a composite of AS-related deaths and hospitalization for heart failure. Results: There were 91 patients (10.8%) with >10% declines in LVEF and 748 patients (89.2%) without declines. Left ventricular dimensions and the prevalence of valve regurgitation and atrial fibrillation or flutter significantly increased in the group with declines in LVEF. The cumulative 3-year incidence of the primary outcome measure was significantly higher in the group with declines in LVEF than in the group with no decline (39.5% vs. 26.5%; p < 0.001). After adjusting for confounders, the excess risk of decline in LVEF over no decline for the primary outcome measure remained significant (hazard ratio: 1.98; 95% confidence interval: 1.29 to 3.06). When stratified by LVEF at index echocardiography (≥70%, 60% to 69%, and <60%), the risk of decline in LVEF on the primary outcome was consistently seen in all the subgroups, without any interaction (p = 0.77). Conclusions: Patients with severe AS with >10% declines in LVEF at 1 year after diagnosis had worse AS-related clinical outcomes than those without declines in LVEF under conservative management. (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis Registry; UMIN000012140) |
著作権等: | © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. The full-text file will be made open to the public on 23 December 2020 in accordance with publisher's 'Terms and Conditions for Self-Archiving'. This is not the published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 |
URI: | http://hdl.handle.net/2433/245213 |
DOI(出版社版): | 10.1016/j.jcin.2019.09.015 |
PubMed ID: | 31857020 |
出現コレクション: | 学術雑誌掲載論文等 |
このリポジトリに保管されているアイテムはすべて著作権により保護されています。