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Cardiac hypertrophy in idiopathic dilated congestive cardiomyopathy: a clinicopathologic study

I J Benjamin, E H Schuster, B H Bulkley

    Circulation
    |September 1, 1981
    PubMed

    Insights

    Patients with idiopathic dilated cardiomyopathy and greater left ventricular (LV) hypertrophy showed better survival. Morphological differences in heart weight and LV wall thickness distinguished short-term from long-term survivors, indicating hypertrophy

    Area of Science:

    • Cardiovascular Pathology
    • Cardiac Morphology
    • Heart Disease Research

    Background:

    • Clinical studies suggest left ventricular (LV) hypertrophy may improve survival in idiopathic dilated cardiomyopathy.
    • Limited morphologic evidence exists to support favorable or unfavorable prognostic groups based on cardiac anatomy.
    • Understanding the relationship between cardiac structure and prognosis is crucial for patient management.

    Purpose of the Study:

    • To investigate the morphologic differences in autopsied hearts of patients with idiopathic dilated cardiomyopathy.
    • To correlate cardiac structural findings with survival duration in dilated cardiomyopathy.
    • To compare the hypertrophy/dilatation index in dilated cardiomyopathy with normal hearts and volume overload conditions.

    Main Methods:

    • Studied 30 autopsied patients with dilated cardiomyopathy, divided into short-term (died within 1 year) and long-term (died 1-14 years) survivors.
    • Measured heart weight, LV wall thickness, and LV cavity diameter (via postmortem angiograms).
    • Calculated an LV hypertrophy/dilatation index (wall thickness/diameter) and compared groups, including normal hearts and volume overload patients.

    Main Results:

    • Long-term survivors had significantly greater average heart weight (759g vs. 540g) and LV wall thickness (1.3cm vs. 1.0cm) compared to short-term survivors (p < 0.001).
    • LV cavity dilatation did not differ significantly between short-term and long-term survivors.
    • The LV hypertrophy/dilatation index was lower in short-term survivors (0.17) and long-term survivors (0.21) of dilated cardiomyopathy compared to volume overload patients (0.38) and normal subjects (0.48).

    Conclusions:

    • In idiopathic dilated cardiomyopathy, LV dilatation is disproportionate to hypertrophy, especially in short-term survivors.
    • Unlike volume overload hypertrophy where wall thickening normalizes the ratio, dilated cardiomyopathy shows impaired adaptation.
    • Morphologic differences in cardiac structure, particularly LV hypertrophy and wall thickness, are associated with survival outcomes in dilated cardiomyopathy.

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