所属 医学部 医学科（東京女子医科大学病院） 職種 講師
|発表タイトル||Predictor of Sudden Cardiac Death in High Risk Patients with Structural Heart Disease: beyond Left
Ventricular Ejection Fraction.
|発表者・共同発表者||◎鈴木敦, 志賀剛, 庄田守男, 萩原誠久|
|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.|