Utility of High-Resolution Magnetocardiography to Predict Later Cardiac Events in Nonischemic Cardiomyopathy Patients With Normal QRS Duration
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- Kawakami Shoji
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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- Takaki Hiroshi
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center
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- Hashimoto Shuji
- Department of Clinical Physiology, National Cerebral and Cardiovascular Center
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- Kimura Yoshitaka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Nakashima Takahiro
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Aiba Takeshi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Kusano Kengo F.
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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- Kamakura Shiro
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Yasuda Satoshi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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- Sugimachi Masaru
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center
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<p>Background:Nonischemic dilated cardiomyopathy (NIDCM) patients, even those with a narrow QRS, are at increased risk for major adverse cardiac events (MACE). We hypothesized that 64-channel magnetocardiography (MCG) would be useful to detect prognostic left intraventricular disorganized conduction (LiDC) by overcoming the limitations of fragmented QRS (fQRS, qualitative definitions, low specificity) and late potential (abnormality undetectable in earlier QRS).</p><p>Methods and Results:We evaluated LiDC on MCG, defined as significant deviation from a global clockwise left ventricular (LV) activation pattern, and conventional noninvasive predictors of MACE, including fQRS and late potential, in 51 NIDCM patients with narrow QRS (LV ejection fraction, 22±7%; QRS duration, 99±11 ms). MACE was defined as cardiac death, lethal ventricular arrhythmias, or LV assist device (LVAD) implantation. LiDC was present in 22 patients. Baseline characteristics were comparable between patients with and without LiDC, except for the ratio of positive late potential. During a mean follow-up of 2.9 years, MACE developed in 16 NIDCM patients (3 cardiac deaths, 9 lethal ventricular arrhythmias, and 4 LVAD). MACE was more incident in patients with LiDC (13/22) than in those without (3/29, P<0.001). Multivariate analysis revealed LiDC, but not fQRS or late potential, as the strongest independent predictor of MACE (hazard ratio 4.28, 95% confidence interval 1.30–19.39, P=0.015).</p><p>Conclusions:MCG accurately depicts LiDC, a promising noninvasive predictor of MACE in patients with NIDCM and normal QRS.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 81 (1), 44-51, 2017
一般社団法人 日本循環器学会
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詳細情報
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- CRID
- 1390282680084619776
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- NII論文ID
- 130005252645
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- NII書誌ID
- AA11591968
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 027807989
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- PubMed
- 27853097
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 使用不可