Estimating postoperative left ventricular volume : Identification of responders to surgical ventricular reconstruction

Wakasa, Satoru; Matsui, Yoshiro; Kobayashi, Junjiro; Cho, Yasunori; Yaku, Hitoshi; Matsumiya, Goro; Isomura, Tadashi; Takanashi, Shuichiro; Usui, Akihiko; Sakata, Ryuzo; Komiya, Tatsuhiko; Sawa, Yoshiki; Saiki, Yoshikatsu; Shimizu, Hideyuki; Yamaguchi, Atsushi; Hamano, Kimikazu; Arai, Hirokuni

Estimating postoperative left ventricular volume : Identification of responders to surgical ventricular reconstruction

Wakasa, Satoru; Matsui, Yoshiro; Kobayashi, Junjiro et al.

Journal of Thoracic and Cardiovascular Surgery, 2018, 156(6), 2088-2096

Permalink : https://hdl.handle.net/2115/76218

このアイテムのアクセス数:821件（2026-10-08 06:40 集計）

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ファイル	フォーマット	サイズ	閲覧回数	説明
1-s2.0-S0022522318320038-mmc1	mp4	76.6 MB	58	Supplementary Data
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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/76218
タイトル	Estimating postoperative left ventricular volume : Identification of responders to surgical ventricular reconstruction
著者	Wakasa, Satoru ; Matsui, Yoshiro ; Kobayashi, Junjiro ; Cho, Yasunori ; Yaku, Hitoshi ; Matsumiya, Goro ; Isomura, Tadashi ; Takanashi, Shuichiro ; Usui, Akihiko ; Sakata, Ryuzo ; Komiya, Tatsuhiko ; Sawa, Yoshiki ; Saiki, Yoshikatsu ; Shimizu, Hideyuki ; Yamaguchi, Atsushi ; Hamano, Kimikazu ; Arai, Hirokuni
e-Rad_Researcher 10374365 著者名 Wakasa, Satoru
e-Rad_Researcher 90219379 著者名 Matsui, Yoshiro
著者名 Kobayashi, Junjiro
著者名 Cho, Yasunori
著者名 Yaku, Hitoshi
著者名 Matsumiya, Goro
著者名 Isomura, Tadashi
著者名 Takanashi, Shuichiro
著者名 Usui, Akihiko
著者名 Sakata, Ryuzo
著者名 Komiya, Tatsuhiko
著者名 Sawa, Yoshiki
著者名 Saiki, Yoshikatsu
著者名 Shimizu, Hideyuki
著者名 Yamaguchi, Atsushi
著者名 Hamano, Kimikazu
著者名 Arai, Hirokuni
言語	英語
キーワード	surgical ventricular reconstruction
	ischemic cardiomyopathy
	coronary artery bypass grafting
	responder
発行日	2018-12
出版者	Elsevier
収録物名	Journal of Thoracic and Cardiovascular Surgery
巻(号)	156(6)
ページ	2088-2096
抄録	Objectives: The postoperative left ventricular end-systolic volume index and ejection fraction are benchmarks of surgical ventricular reconstruction but remain unpredictable. This study aimed to identify who could be associated with a higher long-term survival by adding surgical ventricular reconstruction to coronary artery bypass grafting than coronary artery bypass grafting alone (responders to surgical ventricular reconstruction). Methods: The subjects were 293 patients (median age, 63 years; 255 men) who underwent coronary artery bypass grafting for ischemic heart disease with left ventricular dysfunction in 16 cardiovascular centers in Japan. The relationships among surgical ventricular reconstruction, postoperative end-systolic volume index, ejection fraction, and survival were analyzed to identify responders to surgical ventricular reconstruction. Results: Surgical ventricular reconstruction was performed in 165 patients (56%). The end-systolic volume index and ejection fraction significantly improved (end-systolic volume index, 91 to 64 mL/m2; ejection fraction, 28% to 35%) for all patients. The postoperative end-systolic volume index and ejection fraction were estimated, and surgical ventricular reconstruction was found to be significantly associated with both end-systolic volume index (14.5 mL/m2 reduction, P < .001) and ejection fraction (3.1% increase, P = .003). During the median follow-up of 6.8 years, 69 patients (24%) died. Only the postoperative ejection fraction was significantly associated with survival (hazard ratio, 0.925; 95% confidence interval, 0.885-0.968), although this effect was limited to those with postoperative end-systolic volume index of 40 to 80 mL/m2 in the subgroup analysis (hazard ratio, 0.932; 95% confidence interval, 0.894-0.973). Conclusions: Adding surgical ventricular reconstruction to coronary artery bypass grafting could reduce the mortality risk by increasing ejection fraction for those with a postoperative end-systolic volume index within a specific range. The postoperative end-systolic volume index could demarcate responders to surgical ventricular reconstruction, and its estimation can help in surgical decision making.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
PISSN	0022-5223
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.jtcvs.2018.06.090