イシヅカ　ケンタロウ   Ishidzuka Kentarou   石塚　健太郎    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Diastolic Dysfunction as a Positive Predictor of Recurrent Vascular Events in Patients With Noncardioembolic Stroke.
掲載誌名	正式名：Stroke 略　 称：Stroke ISSNコード：15244628/00392499
掲載区分	国外
巻・号・頁	55(3),pp.595-603
著者・共著者	Ishizuka Kentaro, Hoshino Takao, Mizuno Takafumi, Takahashi Shuntaro, Wako Sho, Arai Satoko, Toi Sono, Kitagawa Kazuo
担当区分	筆頭著者,責任著者
発行年月	2024/03
概要	BACKGROUND:This study aimed to assess the effects of left ventricular diastolic dysfunction (LVDD) on vascular outcomes among patients with stroke of noncardioembolic origins.METHODS:This prospective observational study enrolled 563 patients with noncardioembolic stroke (mean age, 67.9 years; 66.7% men and 33.3% women individuals) registered in the Tokyo Women's Medical University Stroke Registry between 2013 and 2020. Then, patients were divided into the LVDD and non-LVDD groups. The primary outcome was a composite of major adverse cardiovascular events, including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death 1 year after stroke onset. The effect of LVDD on vascular events was assessed using multivariable Cox regression analyses.RESULTS:A total of 130 (23.1%) patients had any grade of LVDD, and patients with LVDD had a higher risk of major adverse cardiovascular event at 1 year than those without LVDD (annual rate, 20.9% versus 10.8%; log-rank P=0.001). The multivariable Cox proportional hazards regression model demonstrated that the presence of LVDD was independently associated with the major adverse cardiovascular event risk (hazard ratio, 1.79 [95% CI, 1.02-3.12]; P=0.019). Furthermore, the LVDD grade was proportional to the risk of major adverse cardiovascular events and recurrent stroke.CONCLUSIONS:LVDD may be associated with further vascular events after a noncardioembolic stroke, suggesting the importance of LVDD evaluations in risk stratification and secondary prevention in patients with noncardioembolic stroke.REGISTRATION:URL: https://upload.umin.ac.jp; Unique identifier: UMIN000031913.
DOI	10.1161/STROKEAHA.123.042548
PMID	38328918