[Long-term follow-up and prognosis of dilated cardiomyopathy]

Between 1969 and 1984, 68 patients with dilated cardiomyopathy (mean age 44 years) were observed for an average period of 45 months. 46 patients (68%) died (17 sudden death, 13 congestive heart failure, 5 other causes and 11 unknown causes) during the observation period according to a cumulative 5-year survival rate of 40%. All patients underwent diagnostic cardiac catheterization. Left ventricular ejection fraction was 32%, left ventricular end-diastolic volume index 195 ml/m2, left ventricular end-diastolic pressure 17 mm Hg and cardiac index 2.7 l/min/m2. The initial hemodynamic findings in the non-survivors and the survivors were statistically not significantly different. The prognostic significance of 12 clinical and hemodynamic parameters was evaluated by multivariate regression analysis (Cox model). Only 3 hemodynamic parameters, namely left ventricular end-diastolic volume, left ventricular end-diastolic pressure and cardiac index, showed prognostic significance in regard to survival. Prognostic evaluation of medical therapy (antiarrhythmic drugs n = 14, vasodilators n = 17, anticoagulation n = 37) revealed an improved cumulative 3-year survival rate (87% versus 46%) only for vasodilators.