ゴトウ　マサユキ   GOTOU Masayuki   後藤　雅之    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Prognostic Implication of First-Degree Atrioventricular Block in Patients With Hypertrophic Cardiomyopathy.
掲載誌名	正式名：Journal of the American Heart Association 略　 称：J Am Heart Assoc ISSNコード：2047-9980
掲載区分	国外
出版社	American Heart Association
巻・号・頁	9(6),pp.e015064
著者・共著者	HIGUCHI Satoshi†, MINAMI Yuichiro*, SHODA Morio, SHIROTANI Shota, SAITO Chihiro, HARUKI Shintaro, GOTO Masayuki, YAGISHITA Daigo, EJIMA Koichiro, HAGIWARA Nobuhisa
発行年月	2020/03
概要	Background The association between first-degree atrioventricular block (AVB) and life-threatening cardiac events in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study sought to investigate whether presence of first-degree AVB was associated with HCM-related death in patients with HCM. Methods and Results We included 414 patients with HCM (mean age, 51±16 years; 64.5% men). The P-R interval was measured at the time of the initial evaluation and patients were classified into those with and without first-degree AVB, which was defined as a P-R interval ≥200 ms. HCM-related death was defined as a combined end point of sudden death or potentially lethal arrhythmic events, heart failure-related death, and stroke-related death. First-degree AVB was noted in 96 patients (23.2%) at time of enrollment. Over a median (interquartile range) follow-up period of 8.8 (4.9-12.9) years, a total of 56 patients (13.5%) experienced HCM-related deaths, including 47 (11.4%) with a combined end point of sudden death or potentially lethal arrhythmic events. In a multivariable analysis that included first-degree AVB and risk factors for life-threatening events, first-degree AVB was independently associated with an HCM-related death (adjusted hazard ratio, 2.41; 95% CI, 1.27-4.58; P=0.007), and this trend also persisted for the combined end point of sudden death or potentially lethal arrhythmic events (adjusted hazard ratio, 2.60; 95% CI, 1.28-5.27; P=0.008). Conclusions In this cohort of patients with HCM, first-degree AVB may be associated with HCM-related death, including the combined end point of sudden death or potentially lethal arrhythmic events.
DOI	10.1161/JAHA.119.015064
PMID	32146896