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Non-invasive predictors of short and long-term survival in dilated cardiomyopathy
Insights
Dilated cardiomyopathy (DCM) survival can be predicted by echocardiogram measurements. A mean ventricular wall thickness of 0.9 cm and a hypertrophy-dilation index greater than 0.10 indicate longer survival.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Dilated cardiomyopathy (DCM) is associated with a poor prognosis.
- Identifying non-invasive predictors of survival in DCM patients is crucial for clinical management.
Purpose of the Study:
- To investigate non-invasive echocardiogram (E), radionuclide angiography (RNA), and electrocardiogram (ECG) parameters predictive of survival in DCM patients.
- To differentiate between short-term survivors (died within 1 year) and long-term survivors (survived >1 year).
Main Methods:
- Retrospective review of M-mode echocardiograms, resting radionuclide ventricular function studies, and ECGs from 22 DCM patients.
- Patients were divided into Group I (short-term survivors) and Group II (long-term survivors).
- Comparison of echocardiographic and ECG parameters between the two groups.
Main Results:
- Mean ventricular wall thickness was significantly greater in long-term survivors (0.9 cm) compared to short-term survivors (0.6 cm) (p<0.05).
- A hypertrophy-dilation index was significantly higher in long-term survivors (0.12) versus short-term survivors (0.09) (p<0.05).
- No significant differences were found in left ventricular dimensions (LVDd), left ventricular ejection fraction, or ECG abnormalities between groups.
Conclusions:
- Echocardiographic findings of mean ventricular wall thickness ≥0.9 cm and a hypertrophy-dilation index >0.10 predict survival longer than one year in DCM patients.
- Standard ECG and radionuclide angiography left ventricular ejection fraction are not predictive of outcome in this cohort.
Abstract:
Dilated cardiomyopathy (DCM) carries a poor prognosis. This study examined the non-invasive parameters that may be predictive of survival in two groups of patients, short-term survivors who died within one year of onset of symptoms (Group I, 6 patients) and long-term survivors who survived greater than one year of presentation (Group II, 16 patients). The M-mode echocardiogram (E), resting radionuclide ventricular function study (RNA) and electrocardiogram (ECG) were reviewed for factors that would differentiate between Group I and II. The E mean ventricular wall thickness in Group I was 0.6 cm and Group II 0.9 cm (p less than 0.05), a hypertrophy-dilation index (mean thickness/LVDd) was 0.09 for Group I and 0.12 for Group II (p less than 0.05). There was no significant difference between Groups I and II in LVDd by E, RNA, LV ejection fraction, ECG (LVH, ventricular ectopy, conduction abnormalities). Thus, the finding of a mean ventricular wall thickness of 0.9 cm and a hypertrophy-dilation index of greater than 0.10 by E was predictive of survival longer than one year. The ECG and RNA LV ejection fraction did not predict outcome.