Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure
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概要
- 論文の詳細を見る
Right ventricular (RV) dysfunction has been discussed in relation to an adverse outcome in heart failure (HF). The aim of this study was to analyze the relationship between RV function with HF exacerbation and its subsequent long-term outcome in patients with chronic left-sided HF.We studied 122 consecutive patients who were admitted for dyspnea due to exacerbated left-sided HF with a left ventricular (LV) ejection fraction of less than 40%. Conventional echocardiography was performed in the study subjects on admission and at discharge. Cox proportional hazards analysis revealed that RV end-diastolic dimension (RVDd) (hazard ratio 1.131, P = 0.005, 95% confidence interval 1.039-1.231) and the serum level of creatinine on admission were independent predictors of subsequent cardiac-related death, but RVDd at discharge and other LV parameters were not. Thus, patients were divided into tertiles on the basis of RVDd on admission: < 32 mm (n = 37), 32-40 mm (n = 43), and ≥ 40 mm (n = 42). According to the increase in the RVDd category, the cardiac-related death-free rate significantly decreased. Among the 3 groups, the pulse pressure and serum total bilirubin levels that demonstrated low cardiac output syndrome (LOS) parameters had significant differences.RVDd on admission could be measured noninvasively and easily to predict a worse long-term prognosis of chronic left-sided HF on admission, and showed correlations with LOS parameters.
著者
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Watanabe Ichiro
Department of Cardiology, Nihon University School of Medicine
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Inomata Takayuki
Department Of Cardio-angiology Kitasato University School Of Medicine
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Shinagawa Hisahito
Department Of Cardio-angiology Kitasato University School Of Medicine
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Maekawa Emi
Department Of Biology Graduate School Of Science Osaka University
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Tokita Naoki
Department Of Radiology Kitasato University School Of Medicine
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Koitabashi Toshimi
Department Of Cardio-angiology Kitasato University School Of Medicine
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Mizutani Tomohiro
Department Of Cardio-angiology Kitasato University School Of Medicine
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Inoue Yusuke
Department Of Biomedical Engineering Graduate School Of Medicine The University Of Tokyo
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Yanagisawa Tomoyoshi
Department Of Cardio-angiology Kitasato University School Of Medicine
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Izumi Tohru
Department Of Angio-cardiology Kitasato University School Of Medicine
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Takeuchi Ichiro
Department Of Angio-cardiology Kitasato University School Of Medicine
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