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Circulation, Vol 90, 2772-2779, Copyright © 1994 by American Heart Association
CS Rihal, RA Nishimura, LK Hatle, KR Bailey and AJ Tajik
BACKGROUND: Dilated cardiomyopathy is an important cause of morbidity and
mortality among patients with congestive heart failure. Hemodynamic and
prognostic characterization are critical in guiding selection of medical
and surgical therapies. METHODS AND RESULTS: A cohort of 102 patients with
the clinical diagnosis of dilated cardiomyopathy who underwent
echocardiographic examination between 1986 and 1990 was identified and
followed up through July 1, 1991. Patients with moderate or severe symptoms
had lower indices of systolic function and greater left atrial and right
ventricular dilation. Mitral inflow Doppler signals were characterized by a
restrictive left ventricular filling pattern. In multivariate logistic
regression analysis, deceleration time, ejection fraction, and peak E
velocity were independently associated with symptom status. Over a mean
follow-up of 36 months, 35 patients died. Kaplan-Meier estimated survival
at 1, 2, and 4 years was 84%, 73%, and 61%, respectively, and was
significantly poorer than that of an age- and sex-matched population. The
subgroup with an ejection fraction < 0.25 and deceleration time < 130
milliseconds had a 2-year survival of only 35%. The subgroup with ejection
fraction < 0.25 and deceleration time > 130 milliseconds had an
intermediate 2-year survival of 72%, whereas patients with an ejection
fraction > or = 0.25 had 2-year survivals > or = 95% regardless of
deceleration time. In multivariate analysis, ejection fraction and systolic
blood pressure were independently predictive of subsequent mortality.
Mitral deceleration time was significant in univariate analysis.
CONCLUSIONS: In patients with the clinical diagnosis of dilated
cardiomyopathy, markers of diastolic dysfunction correlated strongly with
congestive symptoms, whereas variables of systolic function were the
strongest predictors of survival. Consideration of both ejection fraction
and deceleration time allowed identification of subgroups with divergent
long-term prognoses.
ARTICLES
Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn.
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|
|
|
|
|
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|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
J. E. Sanderson, S. K. W. Chan, G. Yip, L. Y. C. Yeung, K. W. Chan, K. Raymond, and K. S. Woo Beta-blockade in heart failure: A comparison of carvedilol with metoprolol J. Am. Coll. Cardiol., November 1, 1999; 34(5): 1522 - 1528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
F M Fruhwald, A Fahrleitner, N Watzinger, H Dobnig, M Schumacher, R Maier, R Zweiker, G Leb, and W Klein N-terminal proatrial natriuretic peptide correlates with systolic dysfunction and left ventricular filling pattern in patients with idiopathic dilated cardiomyopathy Heart, November 1, 1999; 82(5): 630 - 633. [Abstract] [Full Text]
|
|
|
|
|
|
F. M. Fruhwald, A. Fahrleitner, N. Watzinger, S. Fruhwald, H. Dobnig, M. Schumacher, R. Maier, R. Zweiker, and W. W. Klein Natriuretic peptides in patients with diastolic dysfunction due to idiopathic dilated cardiomyopathy Eur. Heart J., October 1, 1999; 20(19): 1415 - 1423. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
M. J. Garcia, J. D. Thomas, and A. L. Klein New Doppler echocardiographic applications for the study of diastolic function J. Am. Coll. Cardiol., October 1, 1998; 32(4): 865 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Di Lenarda, R De Maria, A Gavazzi, D Gregori, M Parolini, G Sinagra, L Salvatore, F Longaro, E Bernobich, and F Camerini Long term survival effect of metoprolol in dilated cardiomyopathy Heart, April 1, 1998; 79(4): 337 - 344. [Abstract] [Full Text]
|
|
|
|
|
|
M. D. Cheitlin, J. S. Alpert, W. F. Armstrong, G. P. Aurigemma, G. A. Beller, F. Z. Bierman, T. W. Davidson, J. L. Davis, P. S. Douglas, L. D. Gillam, et al. ACC/AHA Guidelines for the Clinical Application of Echocardiography : A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American Society of Echocardiography Circulation, March 18, 1997; 95(6): 1686 - 1744. [Full Text]
|
|
|
|
|
|
M. Pozzoli, E. Traversi, G. Cioffi, R. Stenner, M. Sanarico, and L. Tavazzi Loading Manipulations Improve the Prognostic Value of Doppler Evaluation of Mitral Flow in Patients With Chronic Heart Failure Circulation, March 4, 1997; 95(5): 1222 - 1230. [Abstract] [Full Text]
|
|
|
|
|
|
K. Yamamoto, J. C. Burnett Jr, M. Jougasaki, R. A. Nishimura, K. R. Bailey, Y. Saito, K. Nakao, and M. M. Redfield Superiority of Brain Natriuretic Peptide as a Hormonal Marker of Ventricular Systolic and Diastolic Dysfunction and Ventricular Hypertrophy Hypertension, December 1, 1996; 28(6): 988 - 994. [Abstract] [Full Text]
|
|
|
|
|
|
S. F. Nagueh, H. A. Kopelen, and M. A. Quinones Assessment of Left Ventricular Filling Pressures by Doppler in the Presence of Atrial Fibrillation Circulation, November 1, 1996; 94(9): 2138 - 2145. [Abstract] [Full Text]
|
|
|
|
|
|
C.M. Yu, J.E. Sanderson, S. Chan, L. Yeung, Y.T. Hung, and K.S. Woo Right Ventricular Diastolic Dysfunction in Heart Failure Circulation, April 15, 1996; 93(8): 1509 - 1514. [Abstract] [Full Text]
|
|
|
|
 |
|
 A. D. Waggoner Where Does Ultrasound Stand in Technology Assessment and Outcomes Research: Issues, Methods, and Questions Journal of Diagnostic Medical Sonography, March 1, 1996; 12(2): 63 - 68. [Abstract] [PDF]
|
|
|
|
 |
|
 J. H. Omens, T. P. Usyk, Z. Li, and A. D. McCulloch Muscle LIM protein deficiency leads to alterations in passive ventricular mechanics Am J Physiol Heart Circ Physiol, February 1, 2002; 282(2): H680 - H687. [Abstract] [Full Text] [PDF]
|
|