ヤマグチ　ジユンイチ   YAMAGUCHI Jiyun'ichi   山口　淳一    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
言語種別	日本語
発表タイトル	Epidemiology, Clinical Features, and Outcome of Concomitant Pneumonia in Hospitalized Patients with Acute Heart Failure
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	ポスター掲示
講演区分	一般
発表者・共同発表者	◎李東磊, 岡山大, 南雄一郎, 中尾梨沙子, 中尾優, 春木伸太郎, 嵐弘之, 指田由紀子, 水野雅之, 山口淳一, 志賀剛, 萩原誠久
発表年月日	2015/04/25
開催地 （都市, 国名）	大阪市
概要	Background: Heart failure may increase risk of pneumonia due to alveoli flooding and reduced microbial clearance. Conversely, pneumonia may induce or worsen heart failure as cardiac output fails to meet the needs during infection. The objective of this study was to clarify the prevalence, clinical features, and prognostic impact of concomitant pneumonia on admission in hospitalized patients with acute heart failure (AHF). Methods and Results: In 395 consecutive patients with AHF (enrolled from April 2007 to August 2012), 63 (15.9%) had concomitant infection on admission. Among these, 26 (41.3%) received a diagnosis of pneumonia; pneumonia was defined by the appearance of a new infiltrate on chest X-ray (N=14) or computed tomography (N=12) accompanied by a fever (≥38ºC) and/or leukocytosis. Patients with pneumonia was older and had lower hemoglobin level than those without. However, there were no significant differences with respect to gender, left ventricular ejection fraction, and B-type natriuretic peptide level between the groups. Concomitant pneumonia on admission was associated with higher in-hospital mortality (odds ratio 2.90; P=0.038). In addition, the probability of 1-year total death among patients with pneumonia was also significantly higher than that among those without (odds ratio 4.35; P<0.001). Conclusions: Pneumonia was about a half of the concomitant infectious disease in hospitalized AHF patients, and was associated with not only short-term outcome, but also medium-term prognosis.