Prediction of left ventricular reverse remodeling after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and ß blockers in patients with idiopathic dilated cardiomyopathy.
Cardiovasc Ultrasound
; 13: 14, 2015 Mar 25.
Article
in En
| MEDLINE
| ID: mdl-25880063
ABSTRACT
BACKGROUND:
Predictors of left ventricular reverse remodeling (LVRR) after therapy with angiotensin converting enzyme inhibitors or angiotensin-receptor blockers and ß blockers in patients with idiopathic dilated cardiomyopathy (IDC) remains unclear.METHODS:
We studied 44 patients with IDC who had been treated with the therapy. LVRR was defined as LV end-diastolic dimension ≤ 55 mm and fractional shortening ≥ 25% at the last echocardiogram.RESULTS:
During a mean follow-up period of 4.7 ± 3.3 years, LVRR occurred in 34% (15/44) of the patients. We divided the patients into 2 groups (1) patients with LVRR (n = 15); (2) patients without LVRR (n = 29). The presence of atrial fibrillation was 40% in patients with LVRR and 14% in those without (p = 0.067). Initial LV end-diastolic dimension was significantly smaller (62 ± 6 vs. 67 ± 6 mm, p = 0.033) in patients with LVRR than in those without. Initial LV end-diastolic dimension of 63.5 mm was an optimal cutoff value for predicting LVRR (sensitivity 67%, specificity 59%, area under the curve 0.70, p = 0.030). When patients were further allocated according to initial LV end-diastolic dimension ≤ 63.5 mm with atrial fibrillation, the combined parameter was a significant predictor of LVRR by univariate logistic regression analysis (odds ratio, 5.78, p = 0.030) (sensitivity 33%, specificity 97%, p = 0.013).CONCLUSIONS:
Combined information on LV end-diastolic dimension and heart rhythm at diagnosis is useful in predicting future LVRR in patients with IDC.
Full text:
1
Database:
MEDLINE
Main subject:
Angiotensin-Converting Enzyme Inhibitors
/
Cardiomyopathy, Dilated
/
Ventricular Remodeling
/
Angiotensin Receptor Antagonists
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Cardiovasc Ultrasound
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
DIAGNOSTICO POR IMAGEM
Year:
2015
Type:
Article
Affiliation country:
Japan