Document Detail


Prevalence and clinical characteristics of nondilated cardiomyopathy and the effect of atrial fibrillation.
MedLine Citation:
PMID:  20211338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of patients with chronic heart failure and those with asymptomatic left ventricular (LV) dysfunction has focused primarily on patients with LV enlargement and a low ejection fraction (EF). Little attention has been paid to those with a normal chamber size and a low EF. We sought to examine the LV geometry and clinical characteristics in such patients with nondilated cardiomyopathy. Of 3,350 transthoracic echocardiograms performed during a 6-month period, 696 showed an EF of < or =0.45. The patients with an end-diastolic diameter of >56 mm, regional wall motion abnormalities, or valvular disease were excluded. Of the 696 patients, 98 met these criteria, and their medical records were reviewed. The average age was 71 +/- 14 years, and 56% were men. Common co-morbidities included hypertension in 52% and atrial fibrillation (AF) in 43%. Only 22% had disabling cardiac symptoms (functional class III or greater). The average end-diastolic dimension was 49 +/- 5 mm, and the EF was 34 +/- 8%. LV hypertrophic remodeling was present in 53%. A second echocardiogram (422 +/- 177 days after the baseline study) was available for 54 patients. The chamber size was unchanged, but the EF had increased from 33 +/- 8% to 40 +/- 14% (p <0.01). The improvement in EF was seen in the group with AF (33 +/- 6% to 44 +/- 15%, p <0.01) but not in those with normal sinus rhythm (33 +/- 9% to 37 +/- 12%, p = NS). In conclusion, 14% of patients with an EF of < or =0.45 had nondilated cardiomyopathy, often with LV hypertrophic remodeling and/or AF. An improvement in LV function can be expected in many patients with nondilated cardiomyopathy, particularly those with AF.
Authors:
Alexander Doumas; Timothy S Draper; Edgar C Schick; William H Gaasch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  2010-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  884-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / complications*
Cardiomyopathies / complications*,  physiopathology,  ultrasonography
Echocardiography
Female
Humans
Hypertrophy, Left Ventricular / complications,  physiopathology,  ultrasonography
Male
Stroke Volume
Ventricular Function, Left
Ventricular Remodeling

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


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