アシハラ キヨウミ   ASHIHARA Kyomi
  芦原 京美
   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 Association of aortic root dilatation with left ventricular function in patients with postoperative ventricular septal defect.
掲載誌名 正式名:Heart and vessels
略  称:Heart Vessels
ISSNコード:0910-8327/1615-2573
掲載区分国内
出版社 Springer Nature
巻・号・頁 34(9),1491-1498頁
著者・共著者 FUKUSHIMA Noritoshi†, FUKUSHIMA Keiko*, SATO Hiroki, SAITO Chihiro, UCHIDA Keiko, YOKOTA Jinko, ASHIHARA Kyomi, HAGIWARA Nobuhisa
発行年月 2019/09
概要 Abstract
Proximal aortic enlargement is associated with an increased risk of heart failure and all-cause mortality. Recently, aortic root dilatation (ARD) was reported in postoperative patients with ventricular septal defects (VSDs). However, the impact of ARD on left ventricular (LV) function in postoperative VSD patients remains unclear. Thus, the aim of this study was to investigate the effect of ARD on LV function in patients with postoperative VSD. One hundred and thirty-five patients (> 15 years of age) with surgically repaired isolated ventricular defects and who underwent transthoracic echocardiography in our institution between 2009 and 2013 were identified. ARD was defined as an observed aortic root diameter/body surface area > 2.1 cm/m2. The propensity score estimating the probability of having ARD adjusted for anatomical and clinical characteristics was calculated. Forty-four patients (32.6%) had ARD. In unadjusted analyses, right ventricular systolic pressure, Tei index, and E/e' were significantly (p < 0.05) higher in patients with ARD than in those without ARD (31.3 ± 7.5 vs. 35.4 ± 13.7 mmHg, 0.32 ± 0.10 vs. 0.44 ± 0.15, and 7.1 ± 1.7 vs. 9.5 ± 2.9, respectively). In the propensity score-adjusted analysis, significant differences in the Tei index and E/e' were confirmed between the two groups (Tei index difference: 0.11, 95% confidence interval 0.05-0.17; E/e' difference: 2.4, 95% confidence interval 1.3-3.5). However, there were no differences in the other echocardiographic measurements. The presence of ARD in patients with postoperative VSD was significantly associated with LV diastolic dysfunction. Thus, surgically repaired VSD patients require careful screening for aortic enlargement and LV function.
DOI 10.1007/s00380-019-01372-7
PMID 30859378