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Slope in preload recruitable stroke work relationship predicts survival after left ventriculoplasty and mitral repair in patients with idiopathic cardiomyopathy

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Title: Slope in preload recruitable stroke work relationship predicts survival after left ventriculoplasty and mitral repair in patients with idiopathic cardiomyopathy
Authors: Shingu, Yasushige Browse this author →KAKEN DB
Kubota, Suguru Browse this author →KAKEN DB
Wakasa, Satoru Browse this author →KAKEN DB
Ooka, Tomonori Browse this author →KAKEN DB
Kato, Hiroki Browse this author
Tachibana, Tsuyoshi Browse this author
Matsui, Yoshiro Browse this author →KAKEN DB
Keywords: Cardiomyopath
Mitral regurgitation
Surgery
Issue Date: Feb-2015
Publisher: Elsevier
Journal Title: Journal of Cardiology
Volume: 65
Issue: 2
Start Page: 157
End Page: 163
Publisher DOI: 10.1016/j.jjcc.2014.04.010
Abstract: Background: Left ventriculoplasty (LVP) and mitral valve plasty (MVP) are sometimes effective for patients with idiopathic dilated cardiomyopathy (DCM) who are not eligible for heart transplantation. Strict patient selection is warrented for these controversial procedures. Methods and Results: The subjects were 18 patients with idiopathic DCM and mitral regurgitation who had not been indicated for heart transplantation due to either older age or patient refusal, and underwent LVP and MVP. Their mean age was 57±14 years and 50% were dependent on catecholamine infusion. The preload recruitable stroke work (PRSW) relationship and its slope (Mw) were estimated by a single-beat technique using transthoracic echocardiography. There were one 30-day mortality and six (33%) hospital deaths due to heart failure. The one-year survival rate was 50%. Left ventricular end-diastolic dimension (LVDd) decreased from 77±11 to 68±11 mm (p = .001) whereas the ejection fraction (LVEF) did not change. Preoperative Mw was significantly higher in one-year survivors than that in non-survivors (54±17 vs. 31±10, erg・cm-3・103, p = .005). Preoperative LVDd was not different between the groups. The cut-off value of 42 erg・cm-3・103 for Mw predicted one-year survival with high sensitivity (100%) and specificity (77%). Conclusions: Mw, the slope in the PRSWrelationship, may predict survival after LVP and MVP in patients with idiopathic DCM.
Rights: © 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/76467
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 新宮 康栄

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