Prolonged QRS Duration and Severity of Mitral Regurgitation are Unfavorable Prognostic Markers of Heart Failure in Patients With Nonischemic Dilated Cardiomyopathy
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概要
- 論文の詳細を見る
Background The goal of the present study was to identify predictors of event-free survival in nonischemic dilated cardiomyopathy (NIDCM) patients after administration of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and β-blockers. Methods and Results The study group comprised 78 consecutive patients with NIDCM between 1997 and 2002. NIDCM was defined as ejection fraction (EF) <0.40 and left ventricular end-diastolic diameter (LVEDD) >55 mm on echocardiography and normal coronary angiography. The mean EF and LVEDD was 26.3±10.5%, and 62.9±7.1 mm, respectively. Patients were treated with optimal medical therapy including ACEI/ARBs and/or β-blockers and followed up for 35.6±27.8 months. The primary endpoint was either cardiac death or hospitalization because of deterioration of heart failure. Cox's regression analysis was used to establish the association of age, sex, EF, LVEDD, left atrial diameter, cardiac index, pulmonary capillary wedge pressure, QRS duration, severity of mitral regurgitation, body mass index, New York Heart Association class and the presence of atrial fibrillation with these events. During follow-up, 23 patients reached the primary endpoint. In a multivariate analysis, EF (chi-square 5.74, p=0.0166), severity of mitral regurgitation (chi-square 12.31, p=0.0004), and QRS duration (chi-square 11.20, p=0.0008) remained significant predictors. Conclusion In NIDCM patients, prolonged QRS duration is a high risk factor for remodeling and unfavorable events. The severity of mitral regurgitation was also a strong risk predictor.
- 社団法人日本循環器学会の論文
- 2005-12-20
著者
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Tanabe Kengo
Division of Cardiology, Mitsui Memorial Hospital
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IKARI Yuji
Division of Cardiology, Tokai University School of Medicine
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Hara Kazuhiro
Division Of Cardiology Mitsui Memorial Hospital
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Hara Kazuhiro
Mitsui Memorial Hospital
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Tanabe Kengo
Division Of Cardiology Mitsui Memorial Hospital
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Amiya Eisuke
Division Of Cardiology Mitsui Memorial Hospital
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Ikari Yuuji
Tokai University
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Tanabe Kengo
Mitsui memorial hospital
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Nakajima Yoshihiro
Division of Cardiology, Mitsui Memorial Hospital
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Ikari Yuji
Division Of Cardiology Tokai University School Of Medicine
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Ikari Yuji
Division Of Cardiology Mitsui Memorial Hospital
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Ikari Yuuji
Mitsui Memorial hospital
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Hara Kazuhiro
Division Of Cardiology Tokai University School Of Medicine
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Ikari Yuji
Department Of Cardiology Tokai University Hospital
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Hara Kazuhiro
Division Of Cardiology Mitui Memorial Hospital
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Kurihara Hiroki
First Department Of Internal Medicine Faculty Of Medicine University Of Tokyo
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Ikari Yuji
Department Of Cardiovascular Medicine Tokai University School Of Medicine
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Hara Kazuhiro
Division Of Cardiology Mistui Memorial Hospital
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Kurihara Hiroki
Division Of Cardiology Mitsui Memorial Hospital
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Ikari Yuji
Department Of Cardiology Tokai University School Of Medicine Nagoya University
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Ikari Yuji
Departments Of Cardiology
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Hara Kazuhiro
First Department Of Internal Medicine Faculty Of Medicine University Of Tokyo
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Ikari Yuji
Center For Cardiovascular Disease
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Ikari Yuji
Division Of Cardiology Mitui Memorial Hospital
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Nakajima Yoshihiro
Division Of Cardiology Mitsui Memorial Hospital
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Hara Kazuhiro
Division Of Cardiology
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Kurihara Hiroki
Center For Cardiovascular Disease Mitsui Memorial Hospital
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