Prognostic value of LV LA volume ratio assessed by 3D echocardiography

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K12853
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 90130:Medical systems-related
• Research Institution: University of Occupational and Environmental Health, Japan
• Principal Investigator: Takeuchi Masaaki 産業医科大学, 大学病院, 准教授 (30236434)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 心臓超音波 / 三次元 / 容量比 / 予後

Outline of Final Research Achievements

The aims of this study were to investigate normal values of new indices, left ventricular eft atrial volume ratio, LVLAVR assessed by 3DE. Significant age dependency of LVLAVR was observed in both sexes, showing that highest and lowest values were observed in the youngest and oldest decades. We also investigated the prognostic value of LVLAVR. Univariate analysis revealed that LVLAVR parameters were significantly associated with future adverse outcome. Kaplan- Meier survival analysis stratified patients into two groups according to the median value of LVLAVR parameters. In multivariate analysis, delta LVLAVR had significant incremental value over age, CKD, and LVEF or age, CKD, and E/e’. With 3DE datasets and fully automated quantification software, we demonstrated the prognostic value of LVLAVR in a diverse group of patients. Since these results were obtained using a fully automated approach, this method facilitates adoption of these indices in a routine clinical setting.

Free Research Field

循環器内科学

Academic Significance and Societal Importance of the Research Achievements

LVLAVRは加齢とともに減少し、潜在性の拡張機能の低下を反映している可能性が示唆された。このことは無症候性の高血圧症例や糖尿病症例でLVLAVRを算出し、より早期の心機能の異常を検出できる可能があり、社会的意義は大きいと考えられる。またLVLAVR、特に拡張末期のLVLAVR、及び拡張末期、収縮末期のLVLAVRの差(Delta LVLAVR)は心疾患患者の予後予測に有用であり、既存の心機能指標より優れていた。予後予測の検討には3次元全自動化ソフトウェアーを用いており、このことから3次元心エコーデータがあれば誰でも簡便に予後予測が可能であり、この点から学術的有用性は極めて高いと考えられる。