Dilated cardiomyopathy: long-term follow-up and predictors of survival

Juillière, Yves; Danchin, Nicolás; Briançon, Serge; Khalifé, K.; Éthevenot, Gérard; Balaud, A.; Gilgenkrantz, J. M.; Pernot, C; Cherrier, F

doi:10.1016/0167-5273(88)90104-0

Cited by 70 publications

(22 citation statements)

References 17 publications

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“…Juillière et al reported that mean systemic arterial pressure was a predictor of the prognosis of DCM. 23 In our study, DCM patients with a higher systemic pressure had a better prognosis, which supports our understanding about blood pressure in our patients.…”

Section: Predictive Variables Of the Prognosis In Dcmsupporting

confidence: 76%

Left Ventricular End-Systolic Wall Stress is a Potent Prognostic Variable in Patients With Dilated Cardiomyopathy

1999

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Dilated cardiomyopathy is an important cause of morbidity and mortality among patients with heart failure. Left ventricular dilation is viewed as a compensatory response to maintain stroke volume, and left ventricular dilation is directly related to the increase of wall stress. However, only a few studies have examined whether wall stress can be a prognostic variable in patients with dilated cardiomyopathy. This study was designed to elucidate whether left ventricular systolic wall stress was related to the prognosis in patients with dilated cardiomyopathy. Twenty-five normal control subjects and 68 patients with dilated cardiomyopathy participated in this study. Hemodynamic parameters and left ventricular systolic wall stress were determined using echocardiography. In addition, the extent score determined by thallium-201 myocardial scintigraphy was measured as an index of cumulative loss of myocardium. During the 53-month follow-up period, 13 patients died of cardiac events. In a stepwise multivariable analysis, end-systolic wall stress and fractional shortening were significant predictors of survival. The extent score was markedly greater in the patients who died than in alive patients. There was a significant correlation between end-systolic wall stress and extent score (r=0.501, p=0.0001). Left ventricular end-systolic wall stress is an important predictor of mortality in patients with dilated cardiomyopathy. (Jpn Circ J 1999; 63: 196 -200)

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Section: Predictive Variables Of the Prognosis In Dcmsupporting

confidence: 76%

Left Ventricular End-Systolic Wall Stress is a Potent Prognostic Variable in Patients With Dilated Cardiomyopathy

1999

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“…An ejection fraction (EF) <30% confers the most adverse prognosis8 but the absolute number of people who suffer SCD is substantially higher in those with EF>35% due to a greater number of those with DCM having an EF>35% 3. LVEF is clearly a marker of disease severity but is neither a specific nor sensitive marker for SCD.…”

Section: Lvef: the Established Risk Stratification Methodsmentioning

confidence: 99%

Towards cardiac MRI based risk stratification in idiopathic dilated cardiomyopathy

Brown

Miller

Marco

et al. 2018

Heart

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Sudden cardiac death (SCD) secondary to arrhythmia remains a risk in those with dilated cardiomyopathy (DCM), an implantable cardiac defibrillator (ICD) is an effective strategy to prevent SCD. Current guidelines recommend selection for ICD based on ejection fraction (EF) less than 35%, however, most SCD occurs in those with EF>35%. Although meta-analysis has demonstrated a survival benefit for primary prevention ICD in DCM, no randomised trial has shown a significant reduction in overall mortality including the most recent ‘Danish Study to Assess the Efficacy of ICDs in Patients With Non-Ischemic Systolic Heat Failure on Mortality’ study. Clearly, a more sophisticated selection strategy is required. Cardiac MRI (CMR) is an ideal non-invasive imaging technique which allows calculation of EF as well as tissue characterisation with gadolinium contrast, parametric mapping and feature tracking. Late gadolinium enhancement detects mid-wall fibrosis in approximately 30% of those with DCM, three meta-analyses have demonstrated an association between fibrosis in DCM and SCD, and those without fibrosis are at low risk of SCD. T1 mapping and extracellular volume (ECV) calculation are methods of demonstrating diffuse fibrosis in the myocardium. Raised ECV and native T1 have been associated with worse outcomes but the relationship to SCD has not been well studied. Undoubtedly, more research is required but CMR has several tools which offer incremental value above EF to improve risk stratification and consequent outcomes and resource utilisation in those with DCM.

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“…A nonconcurrent prospective study in France suggested that the 10-year survival of 1DCM cases with an ejection fraction less than 30% was higher in smokers as compared with nonsmokers [1,2]. Smoking was not predictive of survival in patients with an ejection fraction of at least 30%, however.…”

Section: Discussionmentioning

confidence: 99%

“…Recent follow-up studies of patients with idiopathic dilated cardiomyopathy (IDCM) have paradoxically sug gested that cigarette smokers have an improved prognosis as compared with nonsmokers [1,2], although contrary results have also been reported [3]. Studies of cigarette smoking and survival following acute myocardial infarc tion have been inconsistent [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Does Cigarette Smoking Paradoxically Increase Survival in Idiopathic Dilated Cardiomyopathy?

Metayer¹,

Coughlin²,

Mather³

1996

Cardiology

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Recent studies have suggested that patients with idiopathic dilated cardiomyopathy (IDCM) who smoke have an improved prognosis as compared with nonsmokers. We examined this paradoxical finding using data from a population-based study in Washington, D.C. (n = 127). Current smokers were more likely to have a left-ventricular ejection fraction (LVEF) of 25% or greater as compared with IDCM patients who were past smokers or lifelong nonsmokers (p ≤ 0.02). The cumulative survival among current smokers at 12 and 24 months was 88.1 and 81.4%, respectively, as compared with 77.9 and 71.6% among past smokers and 74.0 and 64.3% among patients who had never smoked. In a univariate analysis using the proportional hazards model, lifelong nonsmokers and former smokers were about twice as likely to die as compared with smokers, although the association was not significant (p > 0.10). In multivariable analysis, older age, LVEF, and ventricular arrhythmias – but not cigarette smoking – were found to be statistically significant independent predictors of survival (p ≤ 0.05).

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Dilated cardiomyopathy: long-term follow-up and predictors of survival

Cited by 70 publications

References 17 publications

Left Ventricular End-Systolic Wall Stress is a Potent Prognostic Variable in Patients With Dilated Cardiomyopathy

Left Ventricular End-Systolic Wall Stress is a Potent Prognostic Variable in Patients With Dilated Cardiomyopathy

Towards cardiac MRI based risk stratification in idiopathic dilated cardiomyopathy

Does Cigarette Smoking Paradoxically Increase Survival in Idiopathic Dilated Cardiomyopathy?

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