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[Natural history of dilated cardiomyopathy]
R Razzolini1, G M Boffa, P Stritoni
1Servizio di Emodinamica, Università degli Studi di Padova.
Insights
Left ventricular function significantly impacts dilated cardiomyopathy prognosis. Survivors show higher pressure/end systolic volume or stress/end systolic volume ratios, indicating better outcomes.
Area of Science:
- Cardiology
- Cardiovascular Research
Context:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Understanding prognostic indicators in DCM is crucial for patient management.
Purpose:
- To investigate the relationship between hemodynamic parameters and prognosis in patients with dilated cardiomyopathy.
- To identify specific left ventricular function indices predictive of survival.
Summary:
- Seventy-seven DCM patients underwent hemodynamic and quantitative angiography. Survivors exhibited higher pressure/end systolic volume ratio or stress/end systolic volume ratio compared to deceased patients.
- A Suga index less than 1 or stress to end systolic volume ratio less than 2.5 indicated a severe prognosis.
- While left ventricular function is linked to prognosis, precise life expectancy assessment remains challenging.
Impact:
- Identifies key left ventricular function parameters for predicting DCM outcomes.
- Highlights the limitations of current parameters in precisely quantifying long-term survival.
- Informs clinical assessment and risk stratification for dilated cardiomyopathy patients.
Abstract:
Seventy-seven patients with dilated cardiomyopathy (50 M and 27 F, aged 38 +/- 16 yrs) were followed up until Dec 31, 1985. Haemodynamic investigation was performed in all cases, and all pressure and left ventricular quantitative angiography parameters were collected. In no case did the coronary angiogram show significant lesions. Mean values of haemodynamic parameters for surviving and deceased patients were compared. Forty-six patients survived and 28 died during the follow-up period. Although all patients had an enlarged left ventricle and depressed contractility, survivors had either greater pressure/end systolic volume ratio or a greater stress/end systolic volume ratio. Survival curves confirm a particularly severe prognosis for patients with Suga index less than 1 or stress to end systolic volume ratio less than 2.5. Mass to volume ratio seems to affect two-year but not late survival. NYHA class does not indicate early survival. In conclusion, left ventricular function is obviously related to prognosis in these patients, but it seems still difficult to assess life expectancy from these parameters alone.