{"title":"扩张型心肌病左心室反向重构成功率和所需时间的最新趋势。","authors":"Masahiro Wanezaki, Tetsu Watanabe, Atsushi Iizuka, Tomoki Kobayashi, Shunsuke Edamura, Takayuki Sugai, Harutoshi Tamura, Satoshi Nishiyama, Ryuhei Yamaguchi, Naoaki Hashimoto, Yoichiro Otaki, Daisuke Kutsuzawa, Shigehiko Kato, Takanori Arimoto, Shunsuke Inoue, Toshiyuki Ko, Seitaro Nomura, Issei Komuro, Masafumi Watanabe","doi":"10.1253/circrep.CR-24-0148","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Left ventricular reverse remodeling (LVRR) is associated with a good prognosis in patients with dilated cardiomyopathy (DCM), so in this study we examined the achievement rates of LVRR, the time taken to LVRR and the factors associated with LVRR in recent cases of DCM.</p><p><strong>Methods and results: </strong>We enrolled 121 patients with DCM. LVRR was defined as a left ventricular ejection fraction ≥40% at follow-up with a ≥10% improvement. LVRR was observed in 82 patients (68%). The median time to LVRR was 208 days. Multivariate analysis revealed that B-type natriuretic peptide (BNP) levels at discharge (per 1-SD increase, odds ratio: 0.483, 95% confidence interval (CI): 0.224-0.963; P=0.0385) and β-blocker dose (per 1-SD increase, odds ratio: 3.379, 95% CI: 1.644-7.702; P=0.0007) were independently associated with LVRR. When the patients were divided into 2 groups according to the first (2007-2017; n=64) and second (2018-2022; n=57) time periods, there was a significantly higher LVRR achievement rate (48.4% vs. 89.5%) and shorter time to LVRR in the second period than in the first.</p><p><strong>Conclusions: </strong>The LVRR achievement rate in DCM has been increasing, and the time to LVRR has been shortened in recent years. Beta-blocker dose and BNP levels at discharge may be strongly associated with LVRR.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"7 2","pages":"97-105"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807696/pdf/","citationCount":"0","resultStr":"{\"title\":\"Recent Trends in Achievement Rates and Time Required for Left Ventricular Reverse Remodeling in Dilated Cardiomyopathy.\",\"authors\":\"Masahiro Wanezaki, Tetsu Watanabe, Atsushi Iizuka, Tomoki Kobayashi, Shunsuke Edamura, Takayuki Sugai, Harutoshi Tamura, Satoshi Nishiyama, Ryuhei Yamaguchi, Naoaki Hashimoto, Yoichiro Otaki, Daisuke Kutsuzawa, Shigehiko Kato, Takanori Arimoto, Shunsuke Inoue, Toshiyuki Ko, Seitaro Nomura, Issei Komuro, Masafumi Watanabe\",\"doi\":\"10.1253/circrep.CR-24-0148\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Left ventricular reverse remodeling (LVRR) is associated with a good prognosis in patients with dilated cardiomyopathy (DCM), so in this study we examined the achievement rates of LVRR, the time taken to LVRR and the factors associated with LVRR in recent cases of DCM.</p><p><strong>Methods and results: </strong>We enrolled 121 patients with DCM. LVRR was defined as a left ventricular ejection fraction ≥40% at follow-up with a ≥10% improvement. LVRR was observed in 82 patients (68%). The median time to LVRR was 208 days. Multivariate analysis revealed that B-type natriuretic peptide (BNP) levels at discharge (per 1-SD increase, odds ratio: 0.483, 95% confidence interval (CI): 0.224-0.963; P=0.0385) and β-blocker dose (per 1-SD increase, odds ratio: 3.379, 95% CI: 1.644-7.702; P=0.0007) were independently associated with LVRR. When the patients were divided into 2 groups according to the first (2007-2017; n=64) and second (2018-2022; n=57) time periods, there was a significantly higher LVRR achievement rate (48.4% vs. 89.5%) and shorter time to LVRR in the second period than in the first.</p><p><strong>Conclusions: </strong>The LVRR achievement rate in DCM has been increasing, and the time to LVRR has been shortened in recent years. Beta-blocker dose and BNP levels at discharge may be strongly associated with LVRR.</p>\",\"PeriodicalId\":94305,\"journal\":{\"name\":\"Circulation reports\",\"volume\":\"7 2\",\"pages\":\"97-105\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807696/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Circulation reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1253/circrep.CR-24-0148\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/10 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1253/circrep.CR-24-0148","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/10 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：扩张型心肌病（DCM）患者的左室反向重构（LVRR）与良好的预后相关，因此本研究探讨了近期DCM患者的左室反向重构成正率、完成左室反向重构所需时间以及与左室反向重构相关的因素。方法和结果：我们纳入121例DCM患者。LVRR定义为随访时左室射血分数≥40%且改善≥10%。82例（68%）患者出现LVRR。达到LVRR的中位时间为208天。多因素分析显示，出院时b型利钠肽（BNP）水平（每增加1-SD），优势比0.483,95%可信区间（CI）： 0.224 ~ 0.963；P=0.0385)和β受体阻滞剂剂量(每增加1-SD，优势比：3.379,95% CI: 1.644-7.702；P=0.0007)与LVRR独立相关。将患者按第一组（2007-2017年）分为两组；N =64)和第二阶段(2018-2022；n=57)个时间段，第二个时间段的LVRR完成率（48.4% vs. 89.5%）明显高于第一个时间段，且到达LVRR的时间明显短于第一个时间段。结论：近年来DCM的LVRR完成率不断提高，LVRR时间缩短。β受体阻滞剂剂量和出院时BNP水平可能与LVRR密切相关。
Recent Trends in Achievement Rates and Time Required for Left Ventricular Reverse Remodeling in Dilated Cardiomyopathy.
Background: Left ventricular reverse remodeling (LVRR) is associated with a good prognosis in patients with dilated cardiomyopathy (DCM), so in this study we examined the achievement rates of LVRR, the time taken to LVRR and the factors associated with LVRR in recent cases of DCM.
Methods and results: We enrolled 121 patients with DCM. LVRR was defined as a left ventricular ejection fraction ≥40% at follow-up with a ≥10% improvement. LVRR was observed in 82 patients (68%). The median time to LVRR was 208 days. Multivariate analysis revealed that B-type natriuretic peptide (BNP) levels at discharge (per 1-SD increase, odds ratio: 0.483, 95% confidence interval (CI): 0.224-0.963; P=0.0385) and β-blocker dose (per 1-SD increase, odds ratio: 3.379, 95% CI: 1.644-7.702; P=0.0007) were independently associated with LVRR. When the patients were divided into 2 groups according to the first (2007-2017; n=64) and second (2018-2022; n=57) time periods, there was a significantly higher LVRR achievement rate (48.4% vs. 89.5%) and shorter time to LVRR in the second period than in the first.
Conclusions: The LVRR achievement rate in DCM has been increasing, and the time to LVRR has been shortened in recent years. Beta-blocker dose and BNP levels at discharge may be strongly associated with LVRR.
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