| Prognostic role of non-sustained ventricular tachycardia in a large cohort of patients with idiopathic dilated cardiomyopathy. | |
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MedLine Citation:
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PMID: 16212073 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The identification of patients with idiopathic dilated cardiomyopathy (IDC) at higher risk of sudden death (SD) is still an unsolved issue, and the role of non-sustained ventricular tachycardia (NSVT) uncertain. METHODS: The effect of NSVT on total mortality, SD and life-threatening arrhythmias was evaluated in 554 patients with IDC on optimal medical treatment and at long-term follow-up (81 +/- 58 months). RESULTS: At diagnosis, 240 patients (43%) had NSVT at Holter monitoring and 314 (57%) did not. During follow-up, 189 patients (5/100 patients-year) died or underwent heart transplantation; SD occurred in 53 patients (1.4/100 patients-year); SD + non-fatal ventricular arrhythmias occurred in 75 patients (2/100 patients-year). Patients with and without NSVT at diagnosis had the same 5-year transplant-free survival rate (76 vs 76%, p = NS) and a similar incidence of SD (10 vs 7%, p = NS). The length and rate of NSVT did not show any significant relationship with the outcome. Only heart failure symptoms (NYHA class III-IV) (hazard ratio [HR] 1.9, p = 0.015) and severe left ventricular impairment (left ventricular ejection fraction < or = 0.30 and left ventricular end-diastolic diameter > or = 70 mm) (HR 2.7, p < 0.0001) were independently associated with higher SD risk. At multivariate analysis the presence of frequent NSVT episodes (> or = 3 runs/day) was associated with an increased risk of total mortality (HR 1.68, p = 0.041) and of major ventricular arrhythmias (HR 2.11, p = 0.037), but only in the subgroup of patients with severe left ventricular impairment. CONCLUSIONS: Patients with advanced heart failure symptoms, severe left ventricular dysfunction and dilation had a higher risk of SD independently of NSVT. The finding of more frequent NSVT was associated with an increased risk of all-cause mortality and of major ventricular arrhythmias in patients with severe left ventricular impairment. |
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Authors:
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Massimo Zecchin; Andrea Di Lenarda; Dario Gregori; Michele Moretti; Mauro Driussi; Aneta Aleksova; Dorita Chersevani; Gastone Sabbadini; Gianfranco Sinagra |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Italian heart journal : official journal of the Italian Federation of Cardiology Volume: 6 ISSN: 1129-471X ISO Abbreviation: Ital Heart J Publication Date: 2005 Sep |
Date Detail:
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Created Date: 2005-10-10 Completed Date: 2006-06-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100909716 Medline TA: Ital Heart J Country: Italy |
Other Details:
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Languages: eng Pagination: 721-7 Citation Subset: IM |
Affiliation:
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Cardiology Department, University of Trieste, Trieste, Italy. massimo.zecchin@aliceposta.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cardiomyopathy, Dilated / complications, diagnosis*, mortality, physiopathology Echocardiography Electrocardiography, Ambulatory Follow-Up Studies Humans Middle Aged Multivariate Analysis Predictive Value of Tests Prognosis Prospective Studies Stroke Volume Survival Analysis Tachycardia, Ventricular / complications, diagnosis*, mortality, physiopathology Ventricular Dysfunction, Left / diagnosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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