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	Mortality and Prognostic Factors in Real-World Japanese Heart Failure Patients with Cardiac Resyn- chronization Therapy.
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	◎志賀剛, 鈴木敦, 庄田守男, 萩原誠久
発表年月日	2015/04/25
開催地 （都市, 国名）	大阪市
概要	Cardiac resynchronization therapy (CRT) can decrease mortality and morbidity in selected heart failure patients with impaired left ventricular (LV) function, and a wide QRS complex. However, not all patients benefit from this therapy. To improve outcomes of CRT patients, further evaluation for prognostic factors will be required. We evaluated 401 consecutive Japanese patients (mean age 60±14 years, 73% men, 19% ischemic) who underwent CRT between 2001 and 2013. During the mean follow-up of 35±31 months, 96 patients (24%) died, 23 patients (6%) received LV assist device (LVAD) and 7 patients (2%) received heart transplantation. Kaplan-Meier curves of probability of freedom from death, transplantation, or LVAD implantation after CRT implantation were shown in Figure. Multivariate analysis showed that renal dysfunction (defined as estimated glomerular filtration rate <60ml/min/1.73m2) as well as non-responder (defined as a reduction ≥15% in LV end-systolic volume) was independently associated with mortality. (Table) Prognostic factors including renal dysfunction is important to identify therapeutic targets in order to improve mortality in the real world patients with CRT.