ヒグチ　サトシ   Higuchi Satoshi   樋口　諭    所属   医学部 医学科（東京女子医科大学病院）    職種   寄附部門講師
論文種別	その他
言語種別	英語
査読の有無	査読なし
表題	Prognostic Significance of the Mitral L-Wave in Patients With Hypertrophic Cardiomyopathy.
掲載誌名	正式名：The American journal of cardiology 略　 称：Am J Cardiol ISSNコード：18791913/00029149
巻・号・頁	130,pp.130-136
著者・共著者	Saito Chihiro, Minami Yuichiro, Arai Kotaro, Haruki Shintaro, Shirotani Shota, Higuchi Satoshi, Ashihara Kyomi, Hagiwara Nobuhisa
発行年月	2020/09
概要	A mitral L-wave indicates advanced diastolic dysfunction with elevated left ventricular filling pressure. Previous studies have reported that the presence of a mitral L-wave is associated with a poor prognosis in patients with heart failure. However, whether the L-wave can predict adverse events in patients with hypertrophic cardiomyopathy (HC) is still unclear. Therefore, we aimed to investigate the prevalence of a mitral L-wave in patients with HC, and the prognosis of patients with or without an L-wave. We analyzed 445 patients with HC. The end points of this study were HC-related death, such as sudden death or potentially lethal arrhythmic events, heart failure-related death, and stroke-related death. A mitral L-wave was defined as a distinct mid-diastolic flow velocity after the E wave with a peak velocity >20 cm/s. The prevalence of an L-wave was 32.4% in patients with HC. Patients with an L-wave were significantly younger, more likely to be women, had higher New York Heart Association functional class, and had a higher prevalence of atrial fibrillation than did patients without an L-wave. Patients with an L-wave had a significantly higher incidence of HC-related death compared with those without an L-wave (log-rank, p < 0.001). The L-wave was an independent determinant of HC-related death in multivariate analysis adjusted for imbalanced baseline variables (adjusted hazard ratio 2.38; 95% confidence interval 1.42 to 4.01; p = 0.001). In conclusion, the presence of a mitral L-wave may be associated with adverse outcome in patients with HC.
DOI	10.1016/j.amjcard.2020.05.040
PMID	32636017