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||Usefulness of Global Left Ventricular Longitudinal Strain during Low-Dose Dobutamine Stress in Patients with Heart Failure Undergoing Cardiac Resynchronization Therapy|
|発表者・共同発表者||◎齋藤千紘, 柳下慈子, 柳下大悟, 新井光太郎, 高木厚, 芦原京美, 庄田守男, 萩原誠久|
|学会抄録||第81回日本循環器学会学術集会 プログラム集 158|
|概要||Aims: The aim of this study was to investigate the clinical impact of left ventricular (LV) global logitudinal strain (GLS) measured at rest and low‒dose dobutamine stress echocardiography (LDSE) on the long‒term outcome in patient with heart failure undergoing cardiac resynchronization therapy (CRT).
Methods and Results:We studied 66 patients with heart failure referred for CRT with QRS ≥120ms and ejection fraction ≤35% underwent LDSE. There were 29 patients (44%) with rest LV GLS >‒9.5% and 32 patients (48%) with stress LV GLS > ‒10.6%. During 4 years, 17 patients (26%) reached the combined primary end point (death, circulatory support, or transplant) and 31patients (47%) reached the secondary end point (heart failure hospitalization or death). Both rest GLS>‒9.5% and stress GLS> ‒10.6% were associated with increased risk of unfavorable events as follows: for the primary end point (hazard ratio=2.42; 95% confidence interval, 1.47‒4.11; P <0.001) and (hazard ratio=3.10; 95% confidence interval, 2.01‒5.45; P <0.001) for the secondary end point (hazard ratio=2.27; 95% confidence interval, 1.41‒3.17; P <0.001) and (hazard ratio=3.38; 95% confidence interval, 2.42‒5.14; P <0.001). The χ2 of the multivariable model to predict primary end point was 7.33 for stress GLS versus 5.77 for rest GLS.
Conclusions:Rest and stress LV GLS during LDSE have the prognostic impacts in patients with heart failure undergoing CRT.