Prognostic Value of Left Atrial Appendage Function in Patients With Dilated Cardiomyopathy
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概要
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The purpose of the present study was to determine whether parameters of left atrial appendage (LAA) function, assessed by transesophageal echocardiography (TEE), could predict the clinical outcome in patients with dilated cardiomyopathy (DCM). Fifty-five patients (20 had ischemic cardiomyopathy; mean age, 56±14 years) who undeawent TEE to evaluate LAA function from 1992 to 1996 were studied. After a mean follow-up period of 34±13 months, 16 patients died; the cause was cardiac in 14 and noncardiac in 2. Patients who died of cardiac cause had a lower LAA emptying valocity than survivors (38±18 vs 54±18cm/s, p=0.01). There were, however, no significant differences between survivors and nonsurvivors with regard to the maximal LAA are (4.3±1.3 vs 4.5±0.9cm^2, p=0.55), minimal LAA area (2.4±1.1 vs 2.9±1.1cm^2, p=0.13), and LAA ejection fraction (46±16 vs 36±18%, p=0.05). On the Cox proportional hazards model analysis, LAA emptying velocity <50cm/s (chi-square 5.9, p=0.02), LAA ejection fraction <43% (chi-square 5.6, p=0.02), female gender (chi-square 5.2, p=0.02), pulmonary artery wedge pressure ≥14mmHg (chi-square 4.8, p=0.03), E/A ratio ≥1.3 (chi-square 4.6, p=0.03), deceleration time <148ms (chi-square 4.6, p=0.03), and caediothoracic ratio ≥54% (chi-square 4.3, p=0.04) were significantly related to cardiac death. The stepwise multivariate analysis reveald that LAA emptying velocity (chi-square 6.1, p=0.01) and gender (chi-square 5.4, p=0.02) were the independent predictors for outcome. In conclusion, the parameters of LAA function may be useful predictors of the clinical outcome in patients with DCM.
- 社団法人日本循環器学会の論文
- 2000-04-20
著者
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Suwa M
Hokusetsu General Hospital
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Suwa Michihiro
The Third Division, Department of Internal Medicine
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Ito Takahide
The Third Division, Department of Internal Medicine, Osaka Medical College
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Kobashi Ayaka
The Third Division,Department of Internal Medicine,Osaka Medical Colleg
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Ito Takahide
Hayama Heart Center
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Hirota Yuzo
The Third Division, Department of Internal Medicine, Osaka Medical College
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Otake Yoshiaki
The Third Division, Department of Internal Medicine, Osaka Medical College
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Hirota Yuzo
The Third Division Department Of Internal Medicine Osaka Medical College
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Hirota Yuzo
Department Of Thoracic Surgery Osaka Medical College
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Hirota Yuzo
The Third Division Department Of Internal Medicine Osaka Medical College Takatsuki
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Otake Yoshiaki
The Third Division Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Dept. Of Intern. Med. Osaka Medical Colledge.
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Suwa Michihiro
3rd Division Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
Third Department Of Internal Medicine Osaka Medical College
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Ito Takahide
The Third Division Department Of Internal Medicine Osaka Medical College
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Kobashi Ayaka
The Third Division Department Of Internal Medicine Osaka Medical Colleg
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Suwa Michihiro
The Third Division Department Of Internal Medicine Osaka Medical College
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Yagi Hatsumi
The Third Division, Department of Internal Medicine, Osaka Medical College
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Yagi Hatsumi
The Third Division Department Of Internal Medicine Osaka Medical College
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Hirota Yuzo
The Third Department Of Internal Medicine Osaka Medical College
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Suwa Michihiro
大阪医科大学
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Ito Takahide
The Third Department Of Internal Medicine Osaka Medical College
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