Changhong Zou1, Xuefei Wu, Qiong Zhou, Yuhui Zhang, Rong Lyu, Jian Zhang2. 1. Heart Failure Care Unit, Heart Failure Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. 2. Email: fwzhangjian62@126.com.
Abstract
OBJECTIVE: To observe the frequency and predictors of recovery of normal left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) in patients with dilated cardiomyopathy (DCM). METHODS: A consecutive cohort of 296 patients with DCM were reviewed and followed up for at least 12 months or to death or cardiac transplantation, to identify those with recovery of normal LVEF, defined as LVEF ≥ 50%, or recovery of normal LVEDD, defined as LVEDD ≤ 55/50 mm for male/female, or both by follow up echocardiography.Variables regarded as potentially relevant to left ventricular function and dimension recovery were evaluated to identify predictors using multivariable logistic regression analysis. RESULTS: After a median follow-up of 28 months, normal LVEF was evidenced in 81 patients (27.4%), normal LVEDD was found in 63 patients (21.3%) and both parameters were recovered in 52 patients (17.6%), LVEF was increased from (31.7 ± 6.3)% to ( 57.5 ± 5.2)% (P < 0.01) and LVEDD decreased from (62.7 ± 4.3) mm to (50.2 ± 3.7) mm (P < 0.01) in these 52 patients. Multivariable logistic regression analysis showed that shorter symptom duration, higher systolic blood pressure at admission, smaller LVEDD and lower LVEF by echocardiography at baseline were independent predictors of subsequent recovery of normal LVEF and LVEDD. CONCLUSION: Current therapy for heart failure could lead to recovery of normal LVEF and LVEDD in part of DCM patients, especially for DCM patients with short symptom duration, higher systolic blood pressure at admission, less enlarged LVEDD and less reduced LVEF at baseline echocardiography.
OBJECTIVE: To observe the frequency and predictors of recovery of normal left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) in patients with dilated cardiomyopathy (DCM). METHODS: A consecutive cohort of 296 patients with DCM were reviewed and followed up for at least 12 months or to death or cardiac transplantation, to identify those with recovery of normal LVEF, defined as LVEF ≥ 50%, or recovery of normal LVEDD, defined as LVEDD ≤ 55/50 mm for male/female, or both by follow up echocardiography.Variables regarded as potentially relevant to left ventricular function and dimension recovery were evaluated to identify predictors using multivariable logistic regression analysis. RESULTS: After a median follow-up of 28 months, normal LVEF was evidenced in 81 patients (27.4%), normal LVEDD was found in 63 patients (21.3%) and both parameters were recovered in 52 patients (17.6%), LVEF was increased from (31.7 ± 6.3)% to ( 57.5 ± 5.2)% (P < 0.01) and LVEDD decreased from (62.7 ± 4.3) mm to (50.2 ± 3.7) mm (P < 0.01) in these 52 patients. Multivariable logistic regression analysis showed that shorter symptom duration, higher systolic blood pressure at admission, smaller LVEDD and lower LVEF by echocardiography at baseline were independent predictors of subsequent recovery of normal LVEF and LVEDD. CONCLUSION: Current therapy for heart failure could lead to recovery of normal LVEF and LVEDD in part of DCMpatients, especially for DCMpatients with short symptom duration, higher systolic blood pressure at admission, less enlarged LVEDD and less reduced LVEF at baseline echocardiography.
Authors: Duraid Younan; T Mark Beasley; David C Pigott; C Blayke Gibson; John P Gullett; Jeffrey Richey; Jean-Francois Pittet; Ahmed Zaky Journal: Crit Ultrasound J Date: 2017-10-11