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Manno T, Shimizu M, Ohomri M, Taomoto Y, Kaneda T, Yamakami Y, Iiya M, Shimada H, Isshiki A, Kimura S, Fujii H, Suzuki M, Hirao K. P4386Prognostic value of pressure-strain curve analysis by echocardiography for cardiac death in patients with congestive heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pressure-strain curve analysis (PS-curve) is novel method of echocardiographic evaluation for left ventricular (LV) systolic myocardial work including the effect of blood pressure. However, the prognostic value of PS-curve for prospective cardiac death in patients with congestive heart failure (CHF).
Purpose
To elucidate the prognostic value of PS-curve analysis for cardiac death in patients with CHF.
Methods
We enrolled 63 consecutive sinus-rhythm patients with CHF admission who were evaluated by PS-curve analysis before discharge (76.0±13.3 years, 39 males). Endpoint was set as all cardiac death.
Results
Observation period was median 327 days [25%: 91, 75%: 656 days], and the longest period was 1004 days. Five patients died for cardiac causes. Multivariate Cox regression analysis (stepwise regression) revealed diastolic blood pressure (BP) and global constructive work (GCW) were independent predictors (Hazard ratio: 0.854, 0.996, P value: 0.016, 0.019, respectively). ROC curve analysis demonstrated GCW ≤601 had high diagnostic performance for cardiac death (specificity 0.891, sensitivity 0.800, area under ROC 0.824). Kaplan-Meyer curve analysis indicated the group with GCW ≤601 was worse cardiac prognosis (Logrank P<0.001).
Cox Hazard Regression Analysis Univariate Multivariate (stepwise regression) Hazard Ratio 95% CI P Hazard Ratio 95% CI P BP systole (mmHg) 0.915 0.85–0.99 0.026 BP diastole (mmHg) 0.915 0.84–0.99 0.043 0.854 0.75–0.97 0.016 LVDd (mm) 1.064 1.01–1.12 0.025 NA LVDs (mm) 1.066 1.01–1.12 0.016 LVEF (%) 0.963 0.91–1.02 0.221 LAD (mm) 1.197 1.06–1.36 0.005 GWE 0.937 0.88–0.99 0.041 GWI 0.998 0.99–0.99 0.041 NA GCW 0.998 0.99–0.99 0.037 0.996 0.99–0.99 0.019 GWW 0.996 0.98–1.01 0.502 Considering multicollinearity, we excluded GWI and LVDd (correlation coefficient: GWI and GCW = 0.979, LVDd and LVDs = 0.942).
Conclusion
Pressure-strain curve analysis had powerful predictive value for cardiac death in patients with CHF.
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Affiliation(s)
- T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Ohomri
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Taomoto
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Kaneda
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Iiya
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - A Isshiki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - K Hirao
- Tokyo Medical and Dental University, Departmentof Cardiology, Tokyo, Japan
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Iiya M, Kimura S, Shimizu M, Fujii H, Suzuki M. P1704The impact of electrocardiographic changes upon resuscitation from out-of-hospital cardiac arrest on mortality. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The serial electrocardiographic changes in patients following out-of-hospital cardiac arrest (OHCA) are unclear.
Purpose
To evaluate serial electrocardiographic changes and to predict all-cause mortality in patients following OHCA.
Methods
We retrospectively studied 101 OHCA patients (70±16 years, 49 male) who achieved a return of spontaneous circulation (ROSC) and survived for ≥3hours. Twelve-lead electrocardiograms (ECGs) were evaluated twice in each patient: initial-ECG, after achieving ROSC; and 2nd-ECG, after receiving the initial evaluation in the emergency room. Patients were divided into two groups: S-group, those surviving for 28 days, and D-group, those dying within 28 days. Multivariate Cox regression analyses were performed to predict the 28-day survival following OHCA. A Kaplan-Meier curve analysis for the 28 day mortality stratified by the QRS morphology and rhythm of initial-ECG was performed.
Results
Among variables of initial-ECG, there were significant differences between the group-S and group-D (table). Multivariate analysis with a step-wise regression demonstrated that age, lactate, and QRS duration of the initial-ECG were significant predictors of all-cause mortality (Odds ratio (OR): 1.04, 1.21, 1.02, p: 0.002, 0.001, 0.001, respectively). Kaplan-Meier analysis revealed that a complete right bundle branch block (CRBBB) of initial-ECG and presence of atrial fibrillation were associated with an increased risk of all-cause mortality (Picture).
Serial change of ECG variables Initial-ECG 2nd-ECG Group S Group D p Group S Group D p Heart Rate [/min] 109±23 105±31 0.527 88±21 94±23 0.341 Af [N,%] 10 (25%) 27 (52%) 0.018* 3 (9%) 6 (26%) 0.134 QRS duration [ms] 111±18 139±33 0.001* 107±29 111±30 0.623 Morphology 0.001* 0.284 – Normal [N,%] 30 (75%) 10 (19%) 29 (81%) 14 (61%) – CRBBB [N,%] 5 (13%) 30 (57%) 5 (14%) 5 (22%) – CLBBB [N,%] 1 (2%) 0 0 1 (4%) – IVCD [N,%] 4 (10%) 13 (24%) 2 (6%) 3 (13%) Comparing variables between group S and group D stratified by initial ECG and delayed ECG. QRS morphology were examined, normal, complete right bundle branch block (CRBBB), complete left bundle branch block (CLBBB), and unspecific interventricular conduction delay (IVCD).
Study flow diagram, KM curve analysis
Conclusions
The QRS duration and morphology upon resuscitation were associated with an increased risk of all-cause mortality following OHCA.
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Affiliation(s)
- M Iiya
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - M Shimizu
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
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Shimizu M, Iiya M, Hara K, Ohmori M, Taomoto Y, Kaneda T, Yamakami Y, Shimada H, Manno T, Isshiki A, Kimura S, Fujii H, Suzuki M, Nishizaki M. P5643Simple 12-leads electrocardiography can predict cardiac death in patients with complete left bundle branch block. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with complete left bundle branch block (CLBBB) generally fall in two categories: CLBBB with good prognosis and poor prognosis. However, a simple electrocardiography (ECG) was considered impossible to predict the two categories.
Purpose
To elucidate the possibility of 12-leads ECG for predicting cardiac prognosis in patients with CLBBB
Methods
To estimate myocardial damage and left ventricular function, the ECG was performed with semiconductor SPECT simultaneously. Among consecutive 5864 patients who underwent ECG gated SPECT, finally 103 sinus-rhythm patients were enrolled. The observed period of them was median 632 days, and primary endpoint was set as cardiac death.
Results
Eight patients fell into cardiac death. Cox univariate analysis showed ventricular activation time (VAT: duration from onset of Q wave to peak of R wave) in V1 lead, T wave amplitude in aVR (aVR T-amp), and multiple fragmented QRS (At least 2 fQRS in LV anterior/inferior/lateral wall), and left ventricular ejection fraction, standard deviation of phase analysis (Phase SD), and summed rest score were significant predictors. After optimization of all significant continuous predictors by ROC curve analysis, all the significant predictors were analyzed by multivariate Cox analysis (stepwise regression). VAT in V1 (Hazard ratio: 4.594, P=0.034), aVR T-amp ≥-85microV (HR: 11.11, P=0.029), and Phase SD≥48.7 (HR6.047, P=0.035) were independent predictors. Kaplan-Meyer curve analysis demonstrated VAT V1≥70 and aVR T amp≥-85 showed the worst prognosis (P=0.008).
Cox Regression after Optimization by ROC Univariate Multivariate (Stepwise regression) HR 95% CI P HR 95% CI P VAT I ≥70 6.861 1.759–26.76 0.006 4.594 1.126–18.75 0.034 T amp in aVR ≥−85 27.34 3.458–216.2 0.002 11.11 1.274–96.85 0.029 Multiple fQRS 3.836 1.081–13.61 0.037 LVEF ≤37% 7.250 1.874–28.04 0.004 SD ≥48.7 17.30 3.671–81.57 <0.001 6.047 1.133–32.28 0.035 SRS≥17 4.178 1.206–14.48 0.024 SD: standard deviation of histogram by phase analysis of SPECT; SRS: summed rest score by myocardial perfusion analysis of SPECT.
Conclusion
Simple 12-leads ECG could predict the prognosis of patients with CLBBB.
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Affiliation(s)
- M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Iiya
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - K Hara
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Ohmori
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Taomoto
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Kaneda
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - A Isshiki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
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Manno T, Shimizu M, Ohomri M, Taomoto Y, Kaneda T, Yamakami Y, Iiya M, Shimada H, Fujii H, Suzuki M, Yamawake N, Nishizaki M, Hirao K. P4728Prognostic value of heart rate variability for cardiac events after discharge in patients with congestive heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Manno
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - M Shimizu
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - M Ohomri
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - Y Taomoto
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - T Kaneda
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - M Iiya
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - N Yamawake
- Yokohama Minami Kyosai Hospital, Dept. of Cardiology, Yokohama, Japan
| | - M Nishizaki
- Odawara Cardiovascular Hospital, Dept. of Cardiology, Odawara, Japan
| | - K Hirao
- Tokyo Medical and Dental University, Dept. of Cardiology, Tokyo, Japan
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Shimizu M, Ohmori M, Taomoto Y, Kaneda T, Yamakami Y, Iiya M, Shimada H, Manno T, Fujii H, Suzuki M, Yamawake N, Nishizaki M. P2760Prognostic value of left ventricular contractile entropy for the presence of chronic total occlusion in coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Ohmori
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Taomoto
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Kaneda
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Iiya
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - N Yamawake
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
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Shimizu M, Ohmori M, Taomoto Y, Kaneda T, Yamakami Y, Iiya M, Shimada H, Manno T, Fujii H, Suzuki M, Yamawake N, Nishizaki M, Sakurada H, Hiraoka M. P4727T-wave amplitude in aVR for left ventricular dyssynchrony in patients with complete left bundle branch block. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Shimizu
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Ohmori
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Taomoto
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Kaneda
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - Y Yamakami
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Iiya
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Shimada
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - T Manno
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - H Fujii
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - M Suzuki
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | - N Yamawake
- Yokohama Minami Kyosai Hospital, Department of Cardiology, Yokohama, Japan
| | | | - H Sakurada
- Tokyo Metropolitan Okubo Hospital, Tokyo, Japan
| | - M Hiraoka
- Tokyo Medical and Dental University, Tokyo, Japan
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Iiya M, Shimizu M, Taomoto Y, Amemiya M, Sato Y, Yamakami Y, Nakamura R, Nakano K, Shimada H, Fujii H, Yamawake N, Nishizaki M. P6431Impact of hemoglobin level for prediction of neurological-full-recovery in patients with out-of-hospital-cardiac-arrest after return-of-spontaneous-circulation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sato Y, Shimizu M, Taomoto Y, Amemiya M, Iiya M, Yamakami Y, Nakamura R, Nakano K, Shimada H, Fujii H, Yamawake N, Nishizaki M, Sakurada H, Hiraoka M. P6427The prognostic value of high-frequency component in holter electrocardiograms on lethal arrhythmia in patients with vasospastic angina. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shimizu M, Taomoto Y, Amemiya M, Yamakami Y, Sato Y, Iiya M, Nakamura R, Nakano K, Shimada H, Fujii H, Yamawake N, Nishizaki M, Sakurada H, Hiraoka M. P881Diagnostic performance of T-axis deviation on 12-leads electrocardiography for myocardial ischemia: Analysis by semiconductor SPECT. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shimizu M, Taomoto Y, Amemiya M, Yamakami Y, Sato Y, Iiya M, Nakamura R, Nakano K, Shimada H, Fujii H, Yamawake N, Nishizaki M, Sakurada H, Hiraoka M. P1458Prognostic value of T wave axis deviation for left ventricular dysfunction in patients with complete left bundle branch block. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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