Document Detail


First- or second-degree atrioventricular block as a risk factor in idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  8447272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate the significance of clinical, hemodynamic and electrocardiographic risk factors in idiopathic dilated cardiomyopathy 94 patients were followed prospectively for 49 +/- 37 months. During follow-up, 30 patients died, 13 died suddenly, 13 died of congestive heart failure and 4 of other causes. Follow-up was completed in 85 patients, and overall cardiac mortality was 31%. Univariate analysis revealed left ventricular ejection fraction among 20 variables as the major indicator of risk of both cardiac death of all causes and sudden cardiac death separately. Multivariate overall analysis determined 3 independent risk factors in the following order for all causes of cardiac death: Ventricular pairs > 40/24 hours (RR 7.2, p < 0.0001), left ventricular ejection fraction < or = 35% (RR 6.5, p < 0.001) and first- or second-degree atrioventricular (AV) block (RR 3.1, p < 0.05). In the subset of patients with ejection fraction < or = 35% ventricular pairs > 40 per 24 hours (RR 10.7, p < 0.001), AV block (RR 3.9, p < 0.05), and the missing administration of vasodilators (RR 3.3, p < 0.05) were the most important. The chief risk factors for sudden cardiac death were age (RR 7.4, p < 0.01) and AV block (RR 4.6, p < 0.05) by adjustment for age, and ejection fraction < or = 35% (RR 7.1, p < 0.01) and AV block (RR 4.2, p < 0.05) if not adjusted for age. A differentiation into 4 risk groups was attempted. The additional independent prognostic importance of AV block was shown, especially in combination with reduced ejection fraction or a high incidence of ventricular pairs.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R Schoeller; D Andresen; P Büttner; K Oezcelik; G Vey; R Schröder
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  71     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-08     Completed Date:  1993-04-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  720-6     Citation Subset:  AIM; IM    
Affiliation:
Medizinische Klinik II (Kardiologie), Deutsches Rotes Kreuz Kliniken Westend, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / complications,  drug therapy
Atrial Fibrillation / complications
Cardiomyopathy, Dilated / complications*,  physiopathology
Cardiovascular Agents / therapeutic use
Death, Sudden, Cardiac*
Female
Follow-Up Studies
Heart Block / complications*,  physiopathology
Hemodynamics
Humans
Male
Middle Aged
Prospective Studies
Risk Factors
Survival Analysis
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

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


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