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Recovery and recurrence of left ventricular systolic dysfunction in patients with idiopathic dilated cardiomyopathy

 Jeonggeun Moon  ;  Young-Guk Ko  ;  Namsik Chung  ;  Jong-Won Ha  ;  Seok-Min Kang  ;  Eui-Young Choi  ;  Se-Joong Rim 
 CANADIAN JOURNAL OF CARDIOLOGY, Vol.25(5) : 147-50, 2009 
Journal Title
Issue Date
Adult ; Aged ; Cardiac Catheterization/methods ; Cardiomyopathy, Dilated/diagnosis* ; Cardiomyopathy, Dilated/drug therapy ; Cardiomyopathy, Dilated/mortality ; Cardiotonic Agents/therapeutic use ; Cohort Studies ; Echocardiography, Doppler ; Electrocardiography ; Female ; Heart Failure, Systolic/diagnosis* ; Heart Failure, Systolic/drug therapy ; Heart Failure, Systolic/mortality ; Heart Function Tests ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Monitoring, Physiologic/methods ; Probability ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Survival Analysis ; Ventricular Dysfunction, Left/diagnosis* ; Ventricular Dysfunction, Left/drug therapy ; Ventricular Dysfunction, Left/mortality ; Ventricular Remodeling/physiology*
Congestive heart failure ; DCMP ; Prognosis
BACKGROUND: Some patients with nonischemic left ventricular (LV) systolic failure recover to have normal LV systolic function. However, few studies on the rates of recovery and recurrence have been reported, and no definitive indicators that can predict the recurrence of LV dysfunction in recovered idiopathic dilated cardiomyopathy (IDCMP) patients have been determined. It was hypothesized that patients who recovered from nonischemic LV dysfunction have a substantial risk for recurrent heart failure.

METHODS: Forty-two patients (32 men) with IDCMP (mean [+/- SD] age 56.9+/-8.7 years) who recovered from systolic heart failure (LV ejection fraction [LVEF] of 26.5+/-6.9% at initial presentation) to a near-normal state (LVEF of 40% or greater, and a 10% increase or greater in absolute value) were monitored for recurrence of LV systolic dysfunction. Patients with significant coronary artery disease were excluded. Patients were monitored for 41.0+/-26.3 months after recovery (LVEF 53.4+/-7.6%) from LV dysfunction.

RESULTS: LV systolic dysfunction reappeared (LVEF 27.5+/-8.1%) during the follow-up period in eight of 42 patients (19.0%). No significant difference between the groups with or without recurrent heart failure was observed in the baseline clinical and echocardiographic characteristics. However, more patients in the recurred IDCMP group than those in the group that maintained the recovery state had discontinued antiheart failure medication (62.5% versus 5.9%, P<0.05).

CONCLUSIONS: LV dysfunction recurs in some patients with reversible IDCMP. The recurrence was significantly correlated with the discontinuation of antiheart failure drugs. The results suggest that continuous medical therapy may be mandatory in patients who recover from LV systolic dysfunction.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Moon, Jeong Geun(문정근)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chung, Nam Sik(정남식)
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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