Dilated cardiomyopathy with re-worsening left ventricular ejection fraction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-06-25

AUTHORS

Takeru Nabeta, Takayuki Inomata, Shunsuke Ishii, Mayu Yazaki, Teppei Fujita, Yuichiro Iida, Yuki Ikeda, Emi Maekawa, Takashi Naruke, Toshimi Koitabashi, Junya Ako

ABSTRACT

Re-worsening left ventricular ejection fraction (LVEF) is observed in some patients with dilated cardiomyopathy (DCM) despite initial improvements in LVEF. We analyzed cardiac outcomes and clinical variables associated with this re-worsening LVEF. A total of 180 newly diagnosed DCM patients who received only pharmacotherapy were enrolled. Echocardiography was performed after 6, 12, 24, and 36 months after initiation of pharmacotherapy. Patients were divided into three groups: (1) Improved: (n = 113, 63%), defined as those > 10% increase in LVEF after 12 months and no decrease (> 10%) between 12 and 36 months; (2) Re-worse: (n = 12, 7%), those with > 10% increase in LVEF after 12 months but with decrease (> 10%) between 12 and 36 months; and (3) Not-improved: (n = 55: 30%), those with no increase in LVEF (> 10%) after 12 months. Patients with re-worse group were older (P = 0.04) and had higher brain natriuretic peptide (BNP) levels after 12 months (P = 0.002) than those in the Improved group. Major cardiac events (sudden death, implantation of a ventricular assist device, and death due to heart failure,) were observed in 13 (7%) patients after 36 months of pharmacotherapy. Multivariate analysis revealed that the Re-worse group had a higher risk for cardiac events (hazard ratio 11.7, 95% confidence interval 1.9–90.7, P = 0.01) than the Improved group, but had a similar risk compared with the Not-improved group. Re-worsening LVEF was associated with poor cardiac outcomes in newly diagnosed DCM patients. Age and persistently high-BNP levels after improvement in LVEF were significantly associated with re-worsening LVEF. More... »

PAGES

95-103

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-018-1214-5

DOI

http://dx.doi.org/10.1007/s00380-018-1214-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105106290

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29942977


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58 natriuretic peptide levels
59 outcomes
60 patients
61 peptide levels
62 pharmacotherapy
63 poor cardiac outcomes
64 risk
65 similar risk
66 total
67 variables
68 ventricular ejection fraction
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