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Non-dilated left ventricular cardiomyopathy vs. dilated cardiomyopathy: clinical background and outcomes

Yuko Eda1, Takeru Nabeta1,2, Saeko Iikura1

  • 1Department of Cardiovascular Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

ESC Heart Failure
|February 6, 2024
PubMed

Insights

Non-dilated left ventricular cardiomyopathy with reduced ejection fraction (NDLVC-REF) showed similar cardiac event rates to dilated cardiomyopathy (DCM). However, NDLVC-REF patients who developed left ventricular dilatation post-diagnosis faced poorer outcomes, necessitating close monitoring.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Heart Failure Research

Background:

  • Non-dilated left ventricular cardiomyopathy (NDLVC) is a proposed cardiomyopathy category characterized by preserved left ventricular (LV) dimensions despite wall motion abnormalities or scar.
  • The clinical profile and prognostic implications of NDLVC, particularly with reduced LV ejection fraction (NDLVC-REF), remained unclear compared to traditional dilated cardiomyopathy (DCM).

Purpose of the Study:

  • To investigate the clinical characteristics and cardiac event rates of patients diagnosed with NDLVC and reduced LV ejection fraction (NDLVC-REF).
  • To compare NDLVC-REF patients with those diagnosed with dilated cardiomyopathy (DCM).

Main Methods:

  • Retrospective analysis of 363 patients with newly diagnosed non-ischemic cardiomyopathy and reduced LV ejection fraction (<50%) from December 2004 to January 2018.
  • Patients were categorized as NDLVC-REF (n=80) if LV dimension index was ≤31 mm/m² (men) or ≤34 mm/m² (women), and as DCM otherwise.
  • Cardiac events included sudden cardiac death and heart failure rehospitalization; follow-up median was 68.8 months.

Main Results:

  • NDLVC-REF patients exhibited a higher prevalence of atrial fibrillation and higher baseline LV ejection fraction compared to DCM patients.
  • LV ejection fraction remained higher and LV end-diastolic diameter smaller in NDLVC-REF versus DCM throughout follow-up.
  • No significant difference in cardiac event rates was observed between NDLVC-REF and DCM groups (P=0.349).
  • A subset of NDLVC-REF patients (14%) who developed LV dilatation post-diagnosis showed a significantly higher risk of cardiac events (P=0.049).

Conclusions:

  • NDLVC-REF and DCM share similar overall cardiac event rates, suggesting comparable long-term prognoses for these conditions.
  • A significant proportion (18%) of NDLVC-REF patients experiencing LV dilatation after diagnosis had poor outcomes.
  • Both NDLVC-REF and DCM patients warrant equivalent clinical attention, regular follow-up, and consistent assessment of LV function.
Abstract

Keywords:
CardiomyopathyHeart failureLeft ventricular functionPrognosis

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