Recovery and relapse of left ventricular systolic dysfunction in hospitalized patients with dilated cardiomyopathy: frequency and related factors
10.3760/cma.j.issn.0253-3758.2015.12.006
- VernacularTitle:扩张型心肌病住院患者左心室收缩功能障碍恢复和复发的发生率及其预测因素
- Author:
Jian ZHANG
1
;
Changhong ZOU
;
Yan HUANG
;
Qiong ZHOU
;
Yuhui ZHANG
;
Rong LYU
Author Information
1. 100037,中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院心力衰竭监护病房
- Keywords:
Dilated cardiomyopathy,dilated;
Recovery of function;
Recurrence;
Foreeasting
- From:
Chinese Journal of Cardiology
2015;43(12):1034-1039
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the frequency and predictors of recovery and relapse of left ventricular systolic dysfunction (LVSD) in hospitalized patients with dilated cardiomyopathy (DCM).Methods Patients with DCM hospitalized in Fuwai Hospital from October 2008 to December 2013 with repeat echocardiography results after discharge were reviewed and followed to December 2014 or until all-cause death or cardiac transplantation.Rate of recovery of LVSD,defined as an absolute increase in left ventricular ejection fraction (LVEF) of ＞ 10％ to a level of ＞50％ on follow-up,and those with relapse of LVSD,defined as a decrease in LVEF to a level of ＜ 45％ after initial recovery was obtained and related factors affecting LVSD recovery and relapse were analyzed.Results After a mean follow-up of (28 ± 17) months,recovery of LVSD was evidenced in 114 of 382 patients (29.8％),LVEF increased from (31.6 ± 6.0) ％ to (55.8 ±3.7) ％ (P ＜0.01) and left ventricular end-diastolic diameter (LVEDD) decreased from (65.1 ± 6.7) mm to (53.5 ± 4.9) mm (P ＜ 0.01) in these patients.Multiple logistic regression analysis showed that symptom duration of heart failure (OR =0.986,P ＜ 0.01),systolic blood pressure (SBP) (OR =1.026,P ＜0.01),LVEDD (OR =0.938,P ＜0.01) andLVEF (OR =1.038,P ＜0.05) at admission were independent predictors of LVSD recovery.During the subsequent follow-up of (24 ± 13) months after initial recovery,17 of 88 patients (19.3％) suffered a relapse of LVSD,LVEF decreased from (54.3±2.6) ％ to (36.6±5.1) ％ (P＜0.01),LVEDD increased from (57.5±4.2) mmto (62.8± 6.8) mm (P ＜0.01) in these patients.Multiple logistic regression analysis showed that less decrease in LVEDD at initial recovery of LVSD was independent predictor of LVSD relapse.Conclusions About 30％ hospitalized patients with DCM experienced LVSD recovery in this patient cohort.Symptom duration of heart failure,SBP,LVEDD and LVEF on admission were predictors of LVSD recover.Moreover,LVSD relapse was observed in around 20％ patients after initial LVSD recovery and less decrease in LVEDD at initial recovery serves as an independent risk factor for LVSD relapse.
