Echocardiography in congestive or dilated cardiomyopathy.

Echocardiography plays an important role in the evaluation of patients with congestive or dilated cardiomyopathy. Its role in diagnosis consists of demonstration of ventricular and atrial chamber dilation and assessment of left ventricular systolic function. A subgroup of patients with depressed function but with no significant left ventricular dilation are described. Echocardiographic detection of intracavitary thrombi in the left ventricular cavity has a high predictive accuracy in excess of 90%. The pathophysiology of mitral and tricuspid regurgitation in relation to annular size, valve dysfunction, and chamber dilation is readily assessed by two-dimensional echocardiography. The Doppler methods are useful to measure cardiac output, to quantify pulmonary hypertension, and to assess left ventricular systolic and diastolic functional abnormalities. An important role of echocardiography in prognosis relates to predictive value of M-mode parameters of left ventricular size, wall thickness, and function in long-term survival, as observed in a prospective multicenter study.