黒田 敏男, 椎名 明, 鈴木 修, 藤田 俊弘, 野田 敏剛, 土谷 正雄, 柳沼 淑夫, 細田 瑳一

Toshio KURODA, Akira SHIINA, Osamu SUZUKI, Toshihiro FUJITA, Toshitaka NODA, Masao TSUCHIYA, Toshio YAGINUMA, Saichi HOSODA

自治医科大学循環器内科

Department of Cardiology, Jichi Medical School

キーワード : Dilated cardiomyopathy, Echocardiography, Cardiac catheterization, Prognosis, Relative wall thickness

　Prognostic value of indices provided by M-mode and two-dimensional echocardiography (Echo) and cardiac catheterization (Cathe) were assessed in patients with dilated cardiomyopathy (DCM). Thirty-six patients (27 males and 9 females) were followed for mean of 4.1 years. Eleven patients died (cardiac death) during 5 years follow-up period. Five-year survival rate in all patients was 39%. Four-year survival rates in patients with cardiac index<3.0, EF<30%, and LVEDV≥150 ml/M² measured by Cathe, was 40%, 50%, and 50%, respectively. In contrast, those in patients with EF<30%, LV diastolic dimension (LVDd)≥50 mm/M², and LAD≥25 mm/M² provided by Echo, were 33%, 45%, and 40%, which were rather lower than those by Cathe. During follow-up period, decreasing EF below 25%, increasing LVDd, and decreasing relative wall thickness below 0.12, resulted in reduced 4-year survival rates of 20%, 33%, and 33%, respectively. In 8 of 9 patients who died during observation period, relative wall thickness decreased significantly, and became below 0.12 in 7 of these 8 patients. In contrast, two patients who showed relative wall thickness below 0.12 at the initial examination and above 0.12 after medical treatment, have improved and survived. We concluded that Echo observation of the patients with DCM could provide useful informations not only for prediction of prognosis but also assessment of effect of medical treatment.