ニイナミ　ヒロシ   Niinami Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Stratification of Destination Therapy Candidates by J-HeartMate Risk Score Among Elderly Non-Responders to Cardiac Resynchronization Therapy.
掲載誌名	正式名：Circulation reports 略　 称：Circ Rep ISSNコード：24340790/24340790
掲載区分	国外
巻・号・頁	4(9),pp.405-411
著者・共著者	Yoshimura Asami†, Kikuchi Noriko, Saito Satoshi, Suzuki Atsushi, Hattori Hidetoshi, Shoda Morio, Ichihara Yuki, Niinami Hiroshi, Hagiwara Nobuhisa, Yamaguchi Junichi, Nunoda Shinichi
発行年月	2022/08/26
概要	Background: For elderly patients with refractory heart failure (HF), destination therapy (DT) with a continuous-flow left ventricular assist device (LVAD) is a possible treatment. The aim of DT is for long-term, satisfying quality of life on LVAD support. Previously, elderly non-responders to cardiac resynchronization therapy (CRT) were primarily destined for palliative care, but DT has been available in Japan since April 30, 2021. This study investigated the prognosis of elderly CRT non-responders and assessed the feasibility of DT in these patients based on the J-HeartMate Risk Score (J-HMRS). Methods and Results: Of the 559 patients who underwent CRT at Tokyo Women's Medical University between 2000 and 2018, 198 were aged 65-75 years. Among these, 76 were identified as non-responders based on echocardiographic data, and were included in this study. We calculated patients' J-HMRS and investigated associations between the J-HMRS and cardiac events after CRT. Patients were divided into 3 groups according to the J-HMRS: low (n=23), medium (n=29), and high (n=24) risk. Patients in the low-risk group experienced as many HF rehospitalizations and ventricular arrhythmia events as those in the other groups. However, survival analysis revealed that, after CRT, survival was higher for patients in the low- compared with high-risk group (P=0.04). Conclusions: The J-HMRS classified 30% of elderly CRT non-responders as low risk and as suitable candidates for DT in Japan.
DOI	10.1253/circrep.CR-22-0074
PMID	36120479