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The prognostic value of a concentric LV structure, however, has not been examined in acute decompensated heart failure (ADHF). Methods This single-center, observational, retrospective, cohort study analyzed 385 consecutive patients hospitalized due to ADHF. On hospital admission, relative wall thickness (RWT) and the ratio of LV mass to LV end-diastolic volume (LVM/LVEDV) were measured by transthoracic echocardiography as markers of a concentric LV structure. The association of either RWT or LVM/LVEDV with all-cause death as the primary outcome was analyzed. Results During the follow-up period (median, 235 days), 95 (25%) patients died. The high-RWT group had a poorer prognosis than the low-RWT group (log-rank test, P = 0.009). High RWT was a significant risk (HR: 1.95, 95% CI: 1.28–2.97, P = 0.002) in the Cox proportional hazard model analysis adjusted by the Get With The Guideline score, which is an established risk score. In contrast, there was no significant difference in survival between the low and high-LVM/LVEDV groups (P = 0.42). In the non-severe valvular disease subgroup, patients with high RWT consistently showed worse survival than the low- RWT group (P = 0.028 by log-rank test, HR: 1.96, 95% CI: 1.24–3.11, P = 0.004). There was no significant difference in survival between the low and high-LVM/LVEDV groups (P = 0.42). Conclusions A concentric LV structure represented by a high RWT was associated with a poor prognosis in ADHF. 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The prognostic impact of a concentric left ventricular structure evaluated by transthoracic echocardiography in patients with acute decompensated heart failure : A retrospective study
http://hdl.handle.net/20.500.12000/46667
http://hdl.handle.net/20.500.12000/4666777590603-fdcf-4752-b20b-bbbb0e5f43f8
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Item type | デフォルトアイテムタイプ(フル)(1) | |||||||||
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公開日 | 2020-09-14 | |||||||||
タイトル | ||||||||||
タイトル | The prognostic impact of a concentric left ventricular structure evaluated by transthoracic echocardiography in patients with acute decompensated heart failure : A retrospective study | |||||||||
言語 | en | |||||||||
作成者 |
Yamaguchi, Satoshi
× Yamaguchi, Satoshi
× 山口, 怜
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アクセス権 | ||||||||||
アクセス権 | embargoed access | |||||||||
アクセス権URI | http://purl.org/coar/access_right/c_f1cf | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Acute heart failure | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Left ventricular geometry | |||||||||
主題 | ||||||||||
言語 | en | |||||||||
主題Scheme | Other | |||||||||
主題 | Transthoracic echocardiography | |||||||||
内容記述 | ||||||||||
内容記述タイプ | Other | |||||||||
内容記述 | Background Left ventricular (LV) wall thickening relative to the LV radius, known as a concentric LV structure, is a mechanism that compensates for pressure overload and is related to the risk of cardiovascular events and heart failure. The prognostic value of a concentric LV structure, however, has not been examined in acute decompensated heart failure (ADHF). Methods This single-center, observational, retrospective, cohort study analyzed 385 consecutive patients hospitalized due to ADHF. On hospital admission, relative wall thickness (RWT) and the ratio of LV mass to LV end-diastolic volume (LVM/LVEDV) were measured by transthoracic echocardiography as markers of a concentric LV structure. The association of either RWT or LVM/LVEDV with all-cause death as the primary outcome was analyzed. Results During the follow-up period (median, 235 days), 95 (25%) patients died. The high-RWT group had a poorer prognosis than the low-RWT group (log-rank test, P = 0.009). High RWT was a significant risk (HR: 1.95, 95% CI: 1.28–2.97, P = 0.002) in the Cox proportional hazard model analysis adjusted by the Get With The Guideline score, which is an established risk score. In contrast, there was no significant difference in survival between the low and high-LVM/LVEDV groups (P = 0.42). In the non-severe valvular disease subgroup, patients with high RWT consistently showed worse survival than the low- RWT group (P = 0.028 by log-rank test, HR: 1.96, 95% CI: 1.24–3.11, P = 0.004). There was no significant difference in survival between the low and high-LVM/LVEDV groups (P = 0.42). Conclusions A concentric LV structure represented by a high RWT was associated with a poor prognosis in ADHF. The lack of association between LVM/LVEDV and mortality may result from methodological issues. | |||||||||
内容記述 | ||||||||||
内容記述タイプ | Other | |||||||||
内容記述 | 学位論文 | |||||||||
出版者 | ||||||||||
言語 | en | |||||||||
出版者 | University of the Ryukyus | |||||||||
言語 | ||||||||||
言語 | eng | |||||||||
資源タイプ | ||||||||||
資源タイプ | doctoral thesis | |||||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_db06 | |||||||||
識別子 | ||||||||||
識別子 | http://hdl.handle.net/20.500.12000/46667 | |||||||||
識別子タイプ | HDL | |||||||||
関連情報 | ||||||||||
識別子タイプ | DOI | |||||||||
関連識別子 | https://doi.org/10.1016/j.ijcard.2018.07.097 | |||||||||
関連情報 | ||||||||||
識別子タイプ | DOI | |||||||||
関連識別子 | https://doi.org/10.1016/j.ijcard.2018.07.097 | |||||||||
収録物識別子 | ||||||||||
収録物識別子タイプ | ISSN | |||||||||
収録物識別子 | 0167-5273 | |||||||||
収録物名 | ||||||||||
言語 | en | |||||||||
収録物名 | International Journal of Cardiology | |||||||||
書誌情報 |
巻 287, p. 73-80, 発行日 2019-07-15 |
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学位授与番号 | ||||||||||
学位授与番号 | 甲第503号 | |||||||||
学位名 | ||||||||||
学位名 | 博士(医学) | |||||||||
言語 | ja | |||||||||
学位授与年月日 | ||||||||||
学位授与年月日 | 2020-03-24 | |||||||||
学位授与機関 | ||||||||||
学位授与機関識別子 | 18001 | |||||||||
学位授与機関識別子Scheme | kakenhi | |||||||||
学位授与機関名 | 琉球大学 | |||||||||
言語 | ja |