Clinical Fate of Reversible Non-Ischemic Left Ventricular Systolic Dysfunction and Its Influencing Factors.
- Author:
Jeong Geun MOON
1
;
Se Joong RIM
;
Jaemin SHIM
;
Chul Min AHN
;
Shin Ae KANG
;
Sungha PARK
;
Eui Young CHOI
;
Young Guk KO
;
Seok Min KANG
;
Jong Won HA
;
Yangsoo JANG
;
Namsik CHUNG
;
Seung Yun CHO
Author Information
- Publication Type:Original Article
- Keywords: Prognosis; Congestive heart failure
- MeSH: Cardiomyopathies; Cardiomyopathy, Alcoholic; Cardiomyopathy, Dilated; Coronary Artery Disease; Echocardiography; Follow-Up Studies; Heart Failure; Heart Failure, Systolic; Humans; Male; Prognosis; Recurrence
- From:Korean Circulation Journal 2006;36(1):53-59
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND AND OBJECTIVES: About 25% of the patients with non-ischemic left ventricular (LV) systolic dysfunction will improve spontaneously. However, little has been known about the fate of the patients stricken with heart failure after recovery from LV dysfunction. We hypothesized that the patients who recovered from non-ischemic LV dysfunction have a substantial risk for recurrent heart failure. SUBJECTS AND METHODS: Fifty patients (32 males, mean age: 54.9+/-12.4 years) who recovered from systolic heart failure (LV ejection fraction; an EF of 28.8+/-7.2% at the initial presentation) to near-normal (LVEF > 40% and a 10% or more increase in the absolute value) were monitored for the recurrence of heart failure. Patients with significant coronary artery disease were excluded. The etiologies of heart failure were idiopathic dilated cardiomyopathy (n=39), alcoholic cardiomyopathy (n=7), adriamycin-induced cardiomyopathy (n=2), and tachycardia-induced cardiomyopathy (n=2). After recovery of LV dysfunction, the patients were followed up for a mean of 41.0+/-26.3 months. RESULTS: In 9 patients (18%), the LV systolic dysfunction recurred during follow-up (LVEF 32.6+/-7.3%). There was no significant difference in the baseline clinical and echocardiographic variables between the patients with and without recurrent heart failure. However, cessation of anti-heart failure medication was more frequently observed in the patients with recurrent LV systolic dysfunction (55.6% vs 4.9%, respectively, p<0.05). CONCLUSION: Recurrent heart failure may ensue in the patients with reversible non-ischemic LV systolic dysfunction. The maintenance of anti-heart failure medication in these patients may be a significant influencing factor for their clinical prognosis.
