Prognostic Impact and Predictors of Ejection Fraction Recovery in Patients With Alcoholic Cardiomyopathy.
Rev Esp Cardiol (Engl Ed)
; 71(8): 612-619, 2018 Aug.
Article
em En, Es
| MEDLINE
| ID: mdl-29650446
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Recovery of left ventricular ejection fraction (LVEF) has been described in alcoholic cardiomyopathy (ACM) after a period of alcohol withdrawal. Nevertheless, the prognostic impact of LVEF recovery in ACM and its determinants have not been studied. We sought to define the role of LVEF improvement in the long-term outcome of ACM and to identify predictors of LVEF recovery in these patients.METHODS:
We evaluated 101 ACM patients during a median follow-up period of 82 months [interquartile range 36-134].RESULTS:
At latest follow-up, 42 patients (42%) showed substantial LVEF recovery defined as an absolute increase in LVEF ≥ 10% to a final value of ≥ 40%. Patients who recovered LVEF had better outcomes than patients who did not (heart transplant or cardiovascular death 1% vs 30%; P <.001). A QRS with <120ms (OR, 6.68; 95%CI, 2.30-19.41), beta-blocker therapy (OR, 3.01; 95%CI, 1.09-8.28), and the absence of diuretics (OR, 3.35; 95%CI, 1.08-10.42) predicted LVEF recovery in multivariate analysis. Although alcohol cessation did not predict LVEF recovery, none of the patients (n=6) who persisted with heavy alcohol consumption recovered LVEF. The rate of patients who recovered LVEF did not differ between abstainers and moderate drinkers (44% vs 45%; P=.9).CONCLUSIONS:
The LVEF recovery is associated with an excellent prognosis in ACM. Beta-blocker treatment, QRS <120ms and absence of diuretics are independent predictors of LVEF recovery. LVEF recovery is similar in moderate drinkers and abstainers.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Volume Sistólico
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Cardiomiopatia Alcoólica
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Função Ventricular Esquerda
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Antagonistas Adrenérgicos beta
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Recuperação de Função Fisiológica
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Rev Esp Cardiol (Engl Ed)
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Espanha