A clinical application of preload stress echocardiography for predicting future hemodynamic worsening in patients with early-stage heart failure

• Material Type: 博士論文
• Title: A clinical application of preload stress echocardiography for predicting future hemodynamic worsening in patients with early-stage heart failure
• Author/Editor: Saijo, Yoshihito; Yamada, Hirotsugu; Kusunose, Kenya; Bando, Mika; Nishio, Susumu; Torii, Yuta; Hirata, Yukina; Seno, Hiromitsu; Matsuura, Tomomi; Ise, Takayuki; Tobiume, Takeshi; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka
• Author Heading: Saijo, Yoshihito; Yamada, Hirotsugu; Kusunose, Kenya; Bando, Mika; Nishio, Susumu; Torii, Yuta; Hirata, Yukina; Seno, Hiromitsu; Matsuura, Tomomi; Ise, Takayuki; Tobiume, Takeshi; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka
• Publication, Distribution, etc.: Wiley Periodicals
• Publication Date: 2018-07-13
• Publication Date (W3CDTF): 2018-07-13
• Alternative Title: 早期心不全患者における心不全増悪のリスク層別化に対する前負荷心エコー図法の臨床応用; Preload stress echocardiography for heart failure
• Periodical title: Echocardiography
• No. or year of volume/issue: 35 10
• Volume: 35
• Issue: 10
• Pages: 1587-1595
• ISSN (Periodical Title): ISSN : 1540-8175
• Degree grantor/type: 徳島大学
• Date Granted: 2018-09-27
• Dissertation Number: 甲第3215号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Diastolic function; Doppler echocardiography; heart failure; stress echocardiography
• Target Audience: 一般
• Note (General): Aim: To improve the prognosis of patients with heart failure, risk stratification in their early stage is important. We assessed whether the change in transmitral flow (TMF) velocity pattern during preload augmentation can predict future hemodynamic worsening in early-stage heart failure patients with impaired relaxation TMF pattern. Methods: We designed a prospective cohort study that included 155 consecutive patients with impaired relaxation (IR) pattern at rest. Preload stress echocardiography was achieved using leg positive pressure (LPP), and changes of TMF pattern during the LPP was observed during baseline echocardiographic examination. The patients whose TMF pattern developed to pseudonormal (PN) pattern throughout the study period were classified into the change to PN group, and patients whose TMF pattern stayed in IR pattern were classified into the stay in IR group. Results: The median follow-up period was 17 months. The average age was 68 ± 11 years old, and 97 patients (63%) were male. Among 155 patients, 27 were classified into the change to PN group. A Cox proportional hazard analysis confirmed that the change in the peak atrial systolic TMF velocity during the LPP (ΔA, hazard ratio = 0.58 per 1SD; 95% CI = 0.39 - 0.88, P = 0.010) was the powerful independent predictor of change into PN pattern. Kaplan-Meier analysis revealed that the patients with ΔA ≤ -7 cm/s had more likely to develop into PN pattern than patients with ΔA > -7 cm/s (P = 0.001). Conclusions: Evaluation of a response in TMF during the LPP might provide an incremental diagnostic value to detect future overt heart failure in patients with early-stage heart failure.
• Format (IMT): application/pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1111/echo.14098
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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