Changes in clinical arrhythmia in patients with heart failure due to dilated cardiomyopathy

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概要

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• Background : In patients with chronic heart failure, various arrhythmias can be observed as a result of myocardial damage, and it is suspected that the change in clinical arrhythmia might have a parallel correlation to the change in the degree of the heart failure. Methods : The study population consisted of 79 patients with idiopathic dilated cardiomyopathy (DCM) and a history of congestive heart failure. They were observed for 41 ± 2 months with conventional pharmacological therapy. Before and after this observation period, they were evaluated by echocardiography and Holter monitoring. The patients were divided into 3 groups in accordance with the change in left ventricular ejection fraction (LVEF), i.e., improved (> +5%) or worsened (< -5%) and unchanged groups, and the number of premature ventricular contraction (PVC) and existence of atrial fibrillation (Afib) were compared among the 3 groups. Results : At the baseline, LVEF was 29 ± 4% and was worsened in 9, improved in 56 and unchanged in 14 patients after the observation period. PVC numbers before and after the observation period and the increase in PVC numbers were significantly higher in the worsened group than the other groups. When PVC number > 3, 500/day before observation was used as a criterion, LVEF worsening was predicted with sensitivity of 0.67 and specificity of 0.59 (P = .042). The population of Afib was changed from 2/9 to 5/9 in the worsened group, however, from 19/56 to 16/56 in the improved group and from 3/14 to 2/14 in the unchanged group. When comparing the change in the basic rhythm after the observation period, worsening of LVEF was significantly correlated with a new onset of Afib (P = .0017). Conclusion : In DCM patients with a history of heart failure, the number of PVCs and the presence of Afib correlated with the worsening of LVEF. Therefore the number of PVCs could possibly be used as a predictor of change in LVEF.

• 北里大学の論文
• 2005-03-31

著者

• Sasaki Takeshi

  Department of Rheumatology, Tohoku University school of Medicine

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Wakisaka Yuko

  Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center

• NIWANO Shinichi

  Department of Cardio-Angiology, Kitasato University School of Medicine

• MORIGUCHI Masahiko

  Department of Cardio-Angiology, Kitasato University School of Medicine

• NIWANO Hiroe

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Izumi Tohru

  北里大学 医学部循環器内科

• Sato Daisuke

  Department of Cardio-angiology, Kitasato University School of Medicine

• Satoh Daisuke

  Department Of Emergency And Critical Care Medicine Kitasato University School Of Medicine

• Nakano Hironari

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Niwano Hiroe

  北里大学 内科

• Niwano Hiroe

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Moriguchi Masahiko

  北里大学 医学部循環器内科学

• Moriguchi Masahiko

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Moriguchi Masahiko

  Department Of Internal Medicine/cardiology Kitasato University School Of Medicine

• Niwano Shinichi

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Niwano Shinichi

  日本不整脈学会

• Sasaki Sae

  Department of Cardio-angiology, Kitasato University School of Medicine

• Yuge Masaru

  Department of Cardio-angiology, Kitasato University School of Medicine

• Imaki Ryuta

  Department of Cardio-angiology, Kitasato University School of Medicine

• Inomata Takayuki

  Department of Cardio-angiology, Kitasato University School of Medicine

• Hirasawa Shoji

  Department of Angio-Cardiology, Kitasato University School of Medicine

• Inomata Takayuki

  北里大学 医学部循環器内科

• Inomata Takayuki

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Wakisaka Yuko

  千葉県循環器病センター 成人先天性疾患診療部

• Miwano Shinichi

  北里大学

• Imaki Ryuta

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Imaki Ryuta

  新潟大学 医歯学総合研究科循環器学

• Niwano Hiroe

  Department Of Internal Medcine Kitasato University School Of Medicine

• Yuge Masaru

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Yuge Masasru

  北里大学 循環器内科学

• Sasaki Sae

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Hirasawa Shoji

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Hirasawa Syoji

  Department Of Internal Medicine/cardiology Kitasato University School Of Medicine

• Wakisaka Yuko

  Department Of Pediatrics National Cardiovascular Center

• Sasaki Takeshi

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Niwano Shinichi

  北里大学 医学部循環器内科学

• Sasaki Takeshi

  Department Of Biotechnology College Of Agriculture Ehime University

• Inomata Takayuki

  Department Of Internal Medicine And Cardiology And Gene Genetcs Kitasato University School Of Medici

• Yuge Masaru

  Department Of Internal Medicine/cardiology Kitasato University School Of Medicine

• Izumi Tohru

  Departments Of Cardio-angiology And Emergency And Critical Care Medicine Kitasato University School

• Niwano Shinichi

  Department Of Cardio-angiology Kitasato University

• Imaki Ryuta

  Department Of Emergency And Critical Care Medicine Kitasato University School Of Medicine

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medcine

• Sasaki Takeshi

  Department Of Agricultural Chemistry Faculty Of Agriculture Ehime University

• Sasaki Takeshi

  Department Of Cardio-angiology Kitasato University

• Izumi Tohru

  Department Of Internal Medicine And Cardiology And Gene Genetcs Kitasato University School Of Medici

• Inomata Takayuki

  北里大学 循環器内科学

• Imaki Ryuta

  Department Of Angio-cardiology Kitasato University School Of Medicine

• Izumi Tohru

  Department Of Angio-cardiology Kitasato University School Of Medicine

• Sasaki Takeshi

  Department Of Internal Medicine/cardiology Kitasato University School Of Medicine

• NIWANO Shinichi

  Department of Cardio-andiology, Kitasato University School of Medicine

• Niwano Shinichi

  Department of Angio-Cardiology, Kitasato University School of Medicine

• Yuge Masaru

  Department of Angio-Cardiology, Kitasato University School of Medicine

• Sasaki Sae

  Department of Angio-Cardiology, Kitasato University School of Medicine

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