Prognostic Impact of Segmental Wall Motion Abnormality in Patients With Idiopathic Dilated Cardiomyopathy
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- Iida Yuichiro
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Inomata Takayuki
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital
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- Kaida Toyoji
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Fujita Teppei
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Ikeda Yuki
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Nabeta Takeru
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Ishii Shunsuke
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Koitabashi Toshimi
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Takeuchi Ichiro
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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- Ako Junya
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
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抄録
<p>The clinical impact of left ventricular (LV) segmental wall motion abnormalities (SWMA) in patients with idiopathic dilated cardiomyopathy (IDCM) has not been well elucidated.</p><p>Among 100 consecutive IDCM patients with follow-up visits, we enrolled 85 after excluding those with left bundle branch block and/or ventricular pacemaker implantation. LV wall motion was assessed using left ventriculography scored for 7 segments according to the American Heart Association classification as follows: 0, normokinesis; 1, hypokinesis; 2, akinesis; and 3, dyskinesis. SWMA were defined as a score dispersion of more than 1 degree among the segments.</p><p>SWMA was exhibited by 26 patients. Kaplan-Meier curves demonstrated that the patients with SWMA (SWMA+) had a significantly higher cardiac event-free rate than the patients without SWMA (P < 0.001). Cox proportional hazards analysis showed that SWMA+ was an independent predictor of cardiac events (P = 0.03; hazard ratio = 3.38; 95% confidence interval [CI], 1.11–10.8). Furthermore, multiple regression analysis showed that SWMA+ was an independent predictor of decreased LV end-systolic dimension index after optimal pharmacotherapy (β = -0.24; 95%CI, -9.12 to -0.73; P = 0.02).</p><p>SWMA is common in patients with IDCM and is independently associated with a poor prognosis and less morphometric and functional improvement of LV in response to pharmacotherapy.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 58 (4), 544-550, 2017
一般社団法人 インターナショナル・ハート・ジャーナル刊行会