[Conventional stress test in patients with dilated cardiomyopathy. Variables with prognostic value. Correlations with...

The variables of conventional stress testing were studied to determine their prognostic value and their correlations with other tests, in 34 patients with dilated cardiomyopathy divided into a first group of 20 in-patients admitted because of acute pulmonary edema (GI), and a second group of 14 stable out-patients (GII), with a mean follow-up of 3 years. The GI-patients had data of more evolved disease as reflected by a lower fractional shortening (13.5 +/- 4.6 vs 17.8 +/- 3.9%; p < 0.05). The only variables with prognostic capacity were functional aerobic incapacity (FAI), and systolic arterial pressure reached on exercise (SAPE), this being applicable only to GI-patients (FAI: 19.6 +/- 17.34 vs 46 +/- 26.4% in alive vs patients who died respectively; p < 0.05) (SAPE: 155 +/- 23.21 vs 127.14 +/- 24.9 mmHg, respectively; p < 0.05). Also a good correlation between the cardiac rate reached on exercise and the cardiothoracic index on chest X-ray was found (p = 0.0001), again, for GI-patients only. The presence of ventricular arrhythmias (VA) on stress testing had a very good correlation with a Holter VA-score (p < 0.0001), this being applicable for both GI and GII patients. The correlations with haemodynamic variables obtained by, basal or post-dobutamine infusion, right catheterism were not good by and large, except between FAI and systemic resistances. It is conclude that: 1) Conventional stress testing provides variables of prognostic value in dilated cardiomyopathy patients but only in those with more evolved disease. These variables are the FAI and the SAPE. 2) The presence of VA during exercise predicts their presence in daily life, and in this case at an earlier phase of the disease. 3) There are not good correlations between the haemodynamic and stress testing variables except in the case of systemic resistances and FAI.