Frequency of Recovery and Relapse in Patients With Nonischemic Dilated Cardiomyopathy on Guideline-Directed Medical Therapy

Gupta, Ankur; Goyal, Prashant; Bahl, Ajay

doi:10.1016/j.amjcard.2014.06.021

Cited by 23 publications

(11 citation statements)

References 25 publications

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“…Moreover, the Kaplan-Meier analysis revealed that the clinical outcomes in cases of low TVI occurred much more frequently within 1.0 to 1.5 years, which usually fell within the time to LVEF recovery. 29,30 The present study has several limitations. First, a fully automated quantitative analysis of scar burden or total LGE was not performed.…”

Section: P Value Between Groups Anterolateral (−) Anterolateral (+)mentioning

confidence: 86%

“…Based on the current study's findings, the association between a Lat‐e′ of >7.8 cm/s and reversibility could account for the LGE (−) site, but Sep‐e′ did not show such a relationship. Moreover, the Kaplan‐Meier analysis revealed that the clinical outcomes in cases of low TVI occurred much more frequently within 1.0 to 1.5 years, which usually fell within the time to LVEF recovery …”

Section: Discussionmentioning

confidence: 99%

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Clinical significance of early‐diastolic tissue velocity imaging of lateral mitral annulus for prognosis of nonischemic left ventricular dysfunction

Kim

Choi³

et al. 2019

J of Clinical Ultrasound

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Purpose We explored the potential of tissue velocity imaging (TVI) for prognosis of nonischemic left ventricular (LV) dysfunction (LVD). Methods We reviewed 138 nonischemic LVD patients (58 ± 14 years) who underwent both cardiac magnetic resonance (CMR) and echocardiography. Septal and lateral mitral annular TVI data were compared with late gadolinium enhancement (LGE) on CMR. During a mean follow‐up of 24 months, recovery (>15%) of LV ejection fraction and clinical outcomes (cardiovascular death and heart failure hospitalization) were assessed. Results LGE was commonly observed in the basal anteroseptal, inferoseptal, and inferior segments, but infrequently observed in the anterolateral segment. LGE was associated with lower early diastolic, septal (Sep‐e′ = 5.2 ± 2.0 vs 6.9 ± 2.0 cm/s, P = .031) and lateral (Lat‐e′ = 7.3 ± 3.0 vs 9.5 ± 2.0 cm/s, P < .001) TVI. The relationship between Lat‐e′ and anterolateral LGE (area under the curve, AUC 0.834) was much better than that between Sep‐e′ and inferoseptal LGE (AUC 0.699). The 60 patients with LVD reversibility revealed higher Lat‐e′ (9.8 ± 2.0 vs 6.7 ± 2.2 cm/s, P < .001) and lower LGE burden (7.3 ± 9.0 vs 22 ± 10%, P < .001), while Lat‐e′ ≤ 7.8 cm/s appeared unfavorable for 31 events patients. On multivariate analyses, Lat‐e′ (HR 0.79, 95% CI 0.63‐0.99, P = .044) and LVD reversibility (HR 0.53, 95% CI 0.16‐0.90, P = .018) were still meaningful together with LGE segments and burden. Conclusion Lat‐e′ was related with LVD reversibility and a significant predictor of clinical outcomes.

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Section: P Value Between Groups Anterolateral (−) Anterolateral (+)mentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Clinical significance of early‐diastolic tissue velocity imaging of lateral mitral annulus for prognosis of nonischemic left ventricular dysfunction

Kim

Choi³

et al. 2019

J of Clinical Ultrasound

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“…Incidentally, 2 of these patients subsequently died, 1 suddenly and unexplained and 1 from worsening HF. Thus, the normalization of LV systolic function in patients with IDC does not necessarily signify the absence of pathology, 24 and we do not recommend cessation of medical therapy in patients with myocardial remission.…”

Section: Discussionmentioning

confidence: 97%

Contemporary Outcome in Patients With Idiopathic Dilated Cardiomyopathy

Broch

Murbræch

Andreassen

et al. 2015

The American Journal of Cardiology

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Outcome is better in patients with idiopathic dilated cardiomyopathy (IDC) than in ischemic heart failure (HF), but morbidity and mortality are nevertheless presumed to be substantial. Most data on the prognosis in IDC stem from research performed before the widespread use of current evidence-based treatment, including implantable devices. We report outcome data from a cohort of patients with IDC treated according to current HF guidelines and compare our results with previous figures: 102 consecutive patients referred to our tertiary care hospital with idiopathic IDC and a left ventricular ejection fraction <40% were included in a prospective cohort study. After extensive baseline work-up, follow-up was performed after 6 and 13 months. Vital status and heart transplantation were recorded. Over the first year of follow-up, the patients were on optimal pharmacological treatment, and 24 patients received implantable devices. Left ventricular ejection fraction increased from 26 ± 10% to 41 ± 11%, peak oxygen consumption increased from 19.5 ± 7.1 to 23.4 ± 7.8 ml/kg/min, and functional class improved substantially (all p values <0.001). After a median follow-up of 3.6 years, 4 patients were dead, and heart transplantation had been performed in 9 patients. According to our literature search, survival in patients with IDC has improved substantially over the last decades. In conclusion, patients with IDC have a better outcome than previously reported when treated according to current guidelines.

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“…[2,25] By contrast, in a study on the frequency of recovery and relapse in 188 patients with DCM who were followed up for 50 ± 31 months, 41% patients improved, with 64% exhibiting sustained improvement and the remaining 36% relapsed in further follow-ups of 36 ± 25 months. [26] …”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy

Lee

Wu³

et al. 2017

Medicine

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Peripartum cardiomyopathy (PPCM), often classified as a form of dilated cardiomyopathy (DCM), is the myocardial dysfunction that occurs in late pregnancy and through the first few postpartum months.The aim of this study is to investigate the differences in the clinical outcomes of PPCM and DCM.Electronic medical records from 1997 to 2011 were retrieved from the Taiwan National Health Insurance Research Database. Patients with PPCM were compared with age- and clinical characteristics-matched patients with DCM. Primary outcomes were 1- and 3-year heart failure (HF) readmission, cardiac death, all-cause mortality, and major adverse cardiovascular events. Secondary outcomes were myocardial infarction, new onset of dialysis, heart transplant, and cerebrovascular accident. Follow-up period was divided into “within the first year” and “after the first year.”A total of 527,979 patients (253,166 females) were hospitalized with a principal diagnosis of HF during 1997 to 2011 period. After excluding patients aged <18 and >50 years, patients with other forms of HF, and those with a history of cerebrovascular accidents or coronary artery disease, 797 patients with PPCM and 1267 patients with DCM were evaluated. Propensity score matching yielded 391 patients in each group. Patients with DCM had a significantly worse prognosis compared to those with PPCM for all primary and secondary outcomes at the 1- and 3-year follow-ups. After 1 year, the HF readmission rate did not significantly differ between the 2 diseases, suggesting that HF medications should be aggressively instituted in patients with PPCM.This is the first study to directly compare the clinical outcomes between age-matched patients with PPCM and DCM. Patients with PPCM had a significantly better prognosis across all cardiovascular endpoints compared to patients with DCM.

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Frequency of Recovery and Relapse in Patients With Nonischemic Dilated Cardiomyopathy on Guideline-Directed Medical Therapy

Cited by 23 publications

References 25 publications

Clinical significance of early‐diastolic tissue velocity imaging of lateral mitral annulus for prognosis of nonischemic left ventricular dysfunction

Clinical significance of early‐diastolic tissue velocity imaging of lateral mitral annulus for prognosis of nonischemic left ventricular dysfunction

Contemporary Outcome in Patients With Idiopathic Dilated Cardiomyopathy

Comparison of clinical outcomes in peripartum cardiomyopathy and age-matched dilated cardiomyopathy

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