Document Detail


Recovery and recurrence of left ventricular systolic dysfunction in patients with idiopathic dilated cardiomyopathy.
MedLine Citation:
PMID:  19417864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Some patients with nonischemic left ventricular (LV) systolic failure recover to have normal LV systolic function. However, few studies on the rates of recovery and recurrence have been reported, and no definitive indicators that can predict the recurrence of LV dysfunction in recovered idiopathic dilated cardiomyopathy (IDCMP) patients have been determined. It was hypothesized that patients who recovered from nonischemic LV dysfunction have a substantial risk for recurrent heart failure.
METHODS: Forty-two patients (32 men) with IDCMP (mean [+/- SD] age 56.9+/-8.7 years) who recovered from systolic heart failure (LV ejection fraction [LVEF] of 26.5+/-6.9% at initial presentation) to a near-normal state (LVEF of 40% or greater, and a 10% increase or greater in absolute value) were monitored for recurrence of LV systolic dysfunction. Patients with significant coronary artery disease were excluded. Patients were monitored for 41.0+/-26.3 months after recovery (LVEF 53.4+/-7.6%) from LV dysfunction.
RESULTS: LV systolic dysfunction reappeared (LVEF 27.5+/-8.1%) during the follow-up period in eight of 42 patients (19.0%). No significant difference between the groups with or without recurrent heart failure was observed in the baseline clinical and echocardiographic characteristics. However, more patients in the recurred IDCMP group than those in the group that maintained the recovery state had discontinued antiheart failure medication (62.5% versus 5.9%, P<0.05).
CONCLUSIONS: LV dysfunction recurs in some patients with reversible IDCMP. The recurrence was significantly correlated with the discontinuation of antiheart failure drugs. The results suggest that continuous medical therapy may be mandatory in patients who recover from LV systolic dysfunction.
Authors:
Jeonggeun Moon; Young-Guk Ko; Namsik Chung; Jong-Won Ha; Seok-Min Kang; Eui-Young Choi; Se-Joong Rim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  25     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-06     Completed Date:  2009-06-11     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e147-50     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiac Catheterization / methods
Cardiomyopathy, Dilated / diagnosis*,  drug therapy,  mortality
Cardiotonic Agents / therapeutic use
Cohort Studies
Echocardiography, Doppler
Electrocardiography
Female
Heart Failure, Systolic / diagnosis*,  drug therapy,  mortality
Heart Function Tests
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Monitoring, Physiologic / methods
Probability
Prognosis
Recurrence
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Ventricular Dysfunction, Left / diagnosis*,  drug therapy,  mortality
Ventricular Remodeling / physiology*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents
Comments/Corrections

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