イナイ　ケイ   Inai Kei   稲井　慶    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
言語種別	日本語
発表タイトル	Ventricular diastolic function determined with a feature tracking method predicts future cardiovascular events in patients with Fontan circulation
会議名	第54回日本小児循環器学会総会・学術集会
主催者	日本小児循環器学会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎高橋辰徳, 椎名由美, 稲井慶
発表年月日	2018/07/05
開催地 （都市, 国名）	横浜市
概要	*一般口演01 画像診断 1 【 Introduction】 The prognostic value of diastolic function in Fontan patients remains unclear. 【Methods】 We prospectively enrolled consecutive patients with Fontan circulation from 2003 to 2016, and performed per protocol cardiac MRI. To assess diastolic function, we measured circumferential and longitudinal early diastolic strain rate (DSRcc and DSRll) in the middle short axis and 4 chamber view of the ventricle(s) using a feature tracking method. We traced both left and right ventricles when present.【 Results】 A total of 80 patients were enrolled. The median DSRcc was 0.63/s [range: 0.12-1.36] and median DSRll was 0.87/s [range: 0.12-4.25]. DSRcc and DSRll showed negative correlations with age (r 0.32, p＜0.01/r 0.37, p＜0.01, respectively), ventricular mass index (r 0.53, p＜0.01/r 0.33, p＜0.01) and showed positive correlations with biventricular end-diastolic volume index (r 0.30, p＜0.01/r 0.29, p＜0.01, respectively), biventricular ejection fraction (r 0.39, p＜0.01/r 0.46, p＜0.01). There was no association between DSRcc, DSRll and CVP, EDP. During the follow-up period (53.0±29.3 months), 24 adverse cardiovascular events occurred (2 deaths, 5 heart failure, 19 arrhythmias, and 1 thromboembolism). Univariate Cox regression analysis showed that DSRll ＜0.79/s predicts future cardiovascular events (hazard ratio [HR] 4.3, p＜0.01) but DSRcc does not (DSRcc ＜0.65/s; HR 1.7, p0.26). The clinical cut-off points were determined from the ROC curve. 【 Conclusions】 In patients with Fontan circulation, DSRll predicts future cardiovascular events.