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エジマ コウイチロウ
Ejima Kouichirou
江島 浩一郎 所属 医学部 医学科（東京女子医科大学病院） 職種 寄附部門准教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Left Ventricular Stimulation With Electrical Latency Predicts Mortality in Patients Undergoing Cardiac Resynchronization Therapy. |
| 掲載誌名 | 正式名：JACC. Clinical electrophysiology 略 称：JACC Clin Electrophysiol ISSNコード：24055018/2405500X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 7(6),pp.796-805 |
| 著者・共著者 | Yagishita Daigo, Yagishita Yoshimi, Kataoka Shohei, Yazaki Kyoichiro, Kanai Miwa, Ejima Koichiro, Shoda Morio, Hagiwara Nobuhisa |
| 発行年月 | 2021/06 |
| 概要 | OBJECTIVES:This study sought to evaluate the prognostic value of the time interval from left ventricular (LV) pacing to the earliest onset of QRS complex (S-QRS) for long-term clinical outcomes in patients who underwent cardiac resynchronization therapy (CRT).BACKGROUND:The electrical latency during LV pacing evaluated by S-QRS is associated with local tissue property, and the S-QRS ≥37 ms has been previously proposed as an independent predictor of mechanical response to CRT.METHODS:This study included 82 consecutive patients with heart failure with reduced LV ejection fraction (≤35%) and a wide QRS complex (≥120 ms) who underwent CRT. Patients were divided into a short S-QRS group (SS-QRS; <37 ms) and a long S-QRS group (LS-QRS; ≥37 ms). The primary endpoint was total mortality, including LV assist device implantation or heart transplantation, whereas the secondary endpoint was total mortality or HF hospitalization.RESULTS:S-QRS was 25.9 ± 5.3 ms in SS-QRS and 51.5 ± 13.7 ms in LS-QRS (p < 0.01), and baseline QRS duration and electrical activation at the LV pacing site (i.e., Q-LV) were similar. During mean follow-up of 44.5 ± 21.1 months, 24 patients (29%) reached the primary endpoint, whereas the secondary endpoints were observed in 47 patients (57%). LS-QRS had significantly worse event-free survival for both endpoints. LS-QRS was an independent predictor of total mortality (hazard ratio: 2.6; 95% confidence interval: 1.11 to 6.12; p = 0.03) and the secondary composite events (hazard ratio: 2.4; 95% confidence interval: 1.31 to 4.33; p < 0.01).CONCLUSIONS:The S-QRS ≥37 ms at the LV pacing site was a significant predictor of total mortality and HF hospitalization. S-QRS-guided optimal LV lead placement is critical in patients who receive CRT. |
| DOI | 10.1016/j.jacep.2020.10.015 |
| PMID | 34167755 |