シガ　ツヨシ   Shiga Tsuyoshi   志賀　剛    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
言語種別	日本語
発表タイトル	Predictor of Sudden Cardiac Death in High Risk Patients with Structural Heart Disease: beyond Left Ventricular Ejection Fraction.
会議名	第79回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	口頭
講演区分	シンポジウム・ワークショップ パネル（公募）
発表者・共同発表者	◎鈴木敦, 志賀剛, 庄田守男, 萩原誠久
発表年月日	2015/04/24
開催地 （都市, 国名）	大阪市
概要	Impaired left ventricular ejection fraction (LVEF) is well-known risk of sudden cardiac death (SCD) in patients with myocardial infarction (MI) or heat failure. However, we reported that Kaplan-Meier estimates of SCD were only 5.1% at 5 years in 4,122 Japanese MI survivors although low LVEF was at increased risk. LVEF itself is not adequate to identify high risk patients with SCD. We previously reported that renal dysfunction might be an independent risk factor for appropriate implantable cardioverter-defibrillator (ICD) therapy in heart failure patients. QRS duration is known to be a predictor of mortality in patients with impaired LVEF. We studied 403 consecutive patients (mean age 59±15 years, 81% men) with structural heart disease who implanted ICD for primary prevention of SCD. During mean follow-up of 37 months, 133 (33%) patients experienced appropriate ICD therapy and SCD. Multivariate analysis showed that filtered QRS duration on signal-averaged electrocardiography as well as LVEF was an independently factor. (Table) Further risk assessment will be required to prevent SCD in the era of ICD.