Document Detail

Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study.
MedLine Citation:
PMID:  21884947     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to determine clinical and demographic predictors of recovery of left ventricular function for subjects with recent onset cardiomyopathy (ROCM).
BACKGROUND: Although ROCM is a frequent reason for consultation and transplantation referral, its prognosis and natural history on contemporary therapy are unknown.
METHODS: In the multicenter IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study, subjects with a left ventricular ejection fraction (LVEF) of ≤0.40, fewer than 6 months of symptom duration, and an evaluation consistent with idiopathic dilated cardiomyopathy or myocarditis were enrolled. LVEF was reassessed at 6 months, and subjects were followed up for 4 years. LVEF and event-free survival were compared by race, sex, and clinical phenotype.
RESULTS: The cohort of 373 persons was 38% female and 21% black, with a mean age of 45 ± 14 years. At entry, 91% were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and 82% were receiving beta-blockers, which increased to 92% and 94% at 6 months. LVEF was 0.24 ± 0.08 at entry and 0.40 ± 0.12 at 6 months (mean increase: 17 ± 13 ejection fraction units). Transplant-free survival at 1, 2, and 4 years was 94%, 92%, and 88%, respectively; survival free of heart failure hospitalization was 88%, 82%, and 78%, respectively. In analyses adjusted for sex, baseline LVEF, and blood pressure, LVEF at 6 months was significantly lower in blacks than in nonblacks (p = 0.02). Left ventricular end-diastolic diameter at presentation was the strongest predictor of LVEF at 6 months (p < 0.0001).
CONCLUSIONS: Outcomes in ROCM are favorable but differ by race. Left ventricular end-diastolic diameter by transthoracic echo at presentation was most predictive of subsequent myocardial recovery. (Genetic Modulation of Left Ventricular Recovery in Recent Onset Cardiomyopathy; NCT00575211).
Dennis M McNamara; Randall C Starling; Leslie T Cooper; John P Boehmer; Paul J Mather; Karen M Janosko; John Gorcsan; Kevin E Kip; G William Dec;
Related Documents :
18831897 - Eprosartan in the primary prevention of cardiac allograft vascular disease: a double-bl...
22693127 - Cavitation of deep lacunar infarcts in patients with first-ever lacunar stroke: a 2-yea...
22543837 - Perioperative myocardial necrosis in patients at high cardiovascular risk undergoing el...
21254897 - Role of complement and perspectives for intervention in ischemia-reperfusion damage.
18831897 - Eprosartan in the primary prevention of cardiac allograft vascular disease: a double-bl...
3567367 - Segment analysis of human coronary arteries.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  58     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-02     Completed Date:  2011-10-24     Revised Date:  2012-10-09    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1112-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Cardiovascular Institute, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Data Bank Information
Bank Name/Acc. No.:
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
African Americans
Cardiomyopathy, Dilated / ethnology*
Middle Aged
Multivariate Analysis
Prospective Studies
Recovery of Function*
Sex Factors
United States / epidemiology
Ventricular Function, Left
Grant Support
Comment In:
J Am Coll Cardiol. 2012 Feb 21;59(8):776; author reply 776-7   [PMID:  22340272 ]
Erratum In:
J Am Coll Cardiol. 2011 Oct 18;58(17):1832

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  First experience with drug-eluting balloons in infrapopliteal arteries restenosis rate and clinical ...
Next Document:  Lipolytic effects of B-type natriuretic peptide(1-32) in adipose tissue of heart failure patients co...