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[Non-invasive evaluation of function in both cardiac ventricles and arrhythmias in patients with dilated
I Piszczek1, K Błaszyk, K Poprawski
1I Kliniki Kardiologii Instytutu Kardiologii AM, Poznaniu.
Insights
Dilated cardiomyopathy patients without left ventricular hypertrophy show severe right heart failure, arrhythmias, and thrombotic risks. These factors contribute to a high incidence of sudden cardiac death in this subgroup.
Area of Science:
- Cardiology
- Medical Imaging
- Electrophysiology
Context:
- Dilated cardiomyopathy (DCM) is a complex cardiac condition.
- Left ventricular hypertrophy (LVH) is a common comorbidity.
- Understanding prognostic factors in DCM is crucial for patient management.
Purpose:
- To investigate the clinical and prognostic differences between DCM patients with and without left ventricular hypertrophy.
- To assess the role of echocardiography and Holter monitoring in identifying high-risk DCM patients.
Summary:
- 19 DCM patients underwent echocardiography and 24-hour ECG monitoring.
- A subgroup of 7 patients with electrocardiographic LVH was compared to those without.
- Patients without LVH exhibited pulmonary hypertension, right ventricular failure, higher arrhythmia (78%) and thrombotic (22%) risks, and a 56% sudden death rate.
Impact:
- Identifies a specific DCM subgroup at significantly higher risk for adverse events.
- Highlights the importance of assessing right ventricular function and arrhythmias in DCM.
- Informs clinical strategies for risk stratification and intervention in dilated cardiomyopathy.
Abstract:
Resting echocardiography with M-mode technique under the control of bidimensional picture and pulsating Doppler ultra sound and a 24-hour ECG with Holter technique were performed in 19 patients with dilated cardiomyopathy (6 females and 13 males; mean age 46 years, mean duration of the disease 23 months). A group of 7 patients with electrocardiographic features of the left ventricle hypertrophy, according to Sokolov index, was distinguished and compared with a group of patients without ventricular hypertrophy. The symptoms of pulmonary hypertension with progressing dilatation and failure of the right cardiac ventricle were found in patients with dilated cardiomyopathy without coexisting hypertrophy, despite of significant deterioration of the contractive function. Cardiac arrhythmias and thrombotic disorders which are hazardous for life were significantly more frequent (78% and 22%, respectively) in this group. Percentage of sudden deaths in these patients was high (56%).