Clinical Characteristics and Prognosis of Fetal Left Ventricular Noncompaction in Japan
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- Ozawa Sayaka W
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Takarada Shinya
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Okabe Mako
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Miyao Nariaki
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Nakaoka Hideyuki
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Ibuki Keijiro
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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- Ichida Fukiko
- Department of Pediatrics, International University of Health and Welfare
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- Hirono Keiichi
- Department of Pediatrics, Graduate school of Medicine, University of Toyama
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抄録
<p>Background:Left ventricular noncompaction (LVNC) is morphologically characterized by numerous prominent trabeculations and a severely thickened, two-layered myocardium. The fetal onset of LVNC has rarely been described.</p><p>Methods and Results:We conducted nationwide retrospective surveys on fetal cardiomyopathy (CM) in Japan from 2010 to 2016, from which 38 fetal patients with CM were enrolled, including 16 patients with LVNC. The rate of diagnostic concordance was 56.3% between fetal and postnatal visits in LVNC patients. The increase in the ratio of noncompacted to compacted (N/C) myocardium was time-dependent throughout the fetal period till birth (LV lateral: 1.6±0.1 to 2.8±0.2; LV apex: 2.0±0.1 to 3.2±0.2). Of all fetuses, 16 (42.1%) died or underwent heart transplantation (HT), with 3 intrauterine deaths. Lower fetal cardiovascular profile score (odds ratio, 26.9; P=0.0266) was a risk factor for death or HT. N/C ratio ≥1.6 at the apex at the first visit was a significant predictor of LVNC (odds ratio, 47.8; P=0.0113).</p><p>Conclusions:This is the first study to reveal the etiology of fetal CM based on results from a nationwide survey in Japan, highlighting the difficulty of diagnosing LVNC in fetal patients. To better understand and manage fetal CM, novel diagnostic criteria of LVNC in fetus should be established.</p>
収録刊行物
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- Circulation Journal
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Circulation Journal 86 (1), 98-105, 2021-12-24
一般社団法人 日本循環器学会
