Splenic Volume Index Determined Using Computed Tomography upon Admission Is Associated with Readmission for Heart Failure Among Patients with Acute Decompensated Heart Failure
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- Maeda Daichi
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Sakane Kazushi
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Kanzaki Yumiko
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Horai Ryoto
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Akamatsu Kanako
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Tsuda Kosuke
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Ito Takahide
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Sohmiya Koichi
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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- Hoshiga Masaaki
- Department of Cardiology, Osaka Medical and Pharmaceutical University
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抄録
<p>The spleen is associated with inflammation, and the size of the spleen is affected by hemodynamic congestion and sympathetic stimulation. However, the association between splenic size and prognosis in patients with heart failure remains unknown. Between January 2015 and March 2017, we analyzed 125 patients with acute decompensated heart failure who were assessed by computed tomography (CT) on the day of admission. The spleen was measured by 3-dimensional CT and then the patients were assigned to groups according to their median splenic volume indexes (SpVi; splenic volume/body surface area). We then compared their baseline characteristics and rates of readmission for heart failure after one year. The median SpVi was 63.7 (interquartile range: 44.7-95.3) cm3/m2. Age did not significantly differ between the groups. Patients with a high SpVi had more significantly enlarged left atria and left ventricles. Multiple regression analysis identified significant positive correlations between SpVi and posterior wall thickness as well as left ventricular mass index. Kaplan-Meier analysis revealed lower event-free rates in the patients with a high, than a low SpVi (P = 0.041, log-rank test). After adjustment for potential cofounding factors, SpVi was independently associated with readmission for heart failure (Hazard ratio, 2.25; 95% confidence interval, 1.01-5.02; P = 0.047). In conclusion, increased splenic volume is independently associated with readmission for heart failure among patients with acute decompensated heart failure.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 62 (3), 584-591, 2021-05-29
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