Spontaneous Clinical and Hemodynamic Improvement in Patients on Waiting List for Heart Transplantation

Anguita, Manuel; Arizón, José M.; Bueno, Gregorio Manzanera; Concha, Manuel; Vallés, F

doi:10.1378/chest.102.1.96

Cited by 6 publications

(1 citation statement)

References 13 publications

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“…It has been reported that a spontaneous improvement in the LV function can be observed in up to 27–50% [1–3] of patients with DCM, but very often these studies also included patients with DCM of known aetiology, such as peripartum cardiomyopathy, alcohol abuse, or even ischaemic heart disease, or had very small sample size [11–14]. It is well known that the mechanisms underlying heart disease in those conditions are different from the idiopathic DCM; similarly, the likelihood of improvement seems to be quite high in secondary forms of DCM.…”

Section: Discussionmentioning

confidence: 99%

Frequency, prognosis and predictors of improvement of systolic left ventricular function in patients with ‘classical’ clinical diagnosis of idiopathic dilated cardiomyopathy

Cicoira

Zanolla

Latina

et al. 2001

European J of Heart Fail

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Ž. In patients with dilated cardiomyopathy DCM of different aetiologies, a variable frequency of improvement in the left Ž . ventricular LV systolic function has been reported, while in patients with a 'classic' idiopathic DCM, the frequency of improvement is still under debate, and clinical and haemodynamic predictors of recovery of the LV function are needed. The aim of the present study was to determine the frequency of improvement in the LV systolic function in idiopathic DCM and to identify predictors of reversibility of the impaired LV contractility. A sample of 98 consecutive patients with idiopathic DCM was retrospectively evaluated. Echocardiographic and Doppler measurements were directly taken from the routine echo-Ž . report. LV systolic function was assessed semiquantitatively using a score index SFSI . According to the improvement in the LV systolic function, the patients were divided into group 1 patients with improvement, and group 2 patients without Ž . improvement. During a follow-up of at least 12 months, 19 patients 19% showed an improvement, with a significant increase Ž . Ž . in the mean SFSI; all these group 1 patients survived without heart transplant; in group 2, 18 patients 23% died and 3 4% Ž . received a heart transplant. Patients in group 1 had a significantly shorter duration of symptoms Ps 0.0045 , a younger age Ž . Ž . Ž . Ž . Ps 0.006 , a shorter DtE Ps 0.04 , a lower SFSI P-0.01 , a worse NYHA class P-0.001 and more frequently had a Ž . history of hypertension P-0.0001 . The same variables were significant predictors of improvement at the univariate analysis.Ž . At the multivariate logistic regression analysis, a shorter duration of symptoms Ps 0.02 , a history of hypertension Ž . Ž . Ps 0.003 , and a worse NYHA class Ps 0.01 were independent predictors of improvement. A relatively large percentage of patients with an idiopathic DCM will have a marked improvement in the LV systolic function. This is more likely to happen in the presence of a short duration of symptoms and a history of hypertension. After an improvement, the prognosis is excellent.

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