Prediction of left ventricular reverse remodeling after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and β blockers in patients with idiopathic dilated cardiomyopathy.

Abstract

BACKGROUND:

Predictors of left ventricular reverse remodeling (LVRR) after therapy with angiotensin converting enzyme inhibitors or angiotensin-receptor blockers and β blockers in patients with idiopathic dilated cardiomyopathy (IDC) remains unclear.

METHODS:

We studied 44 patients with IDC who had been treated with the therapy. LVRR was defined as LV end-diastolic dimension ≤ 55 mm and fractional shortening ≥ 25% at the last echocardiogram.

RESULTS:

During a mean follow-up period of 4.7 ± 3.3 years, LVRR occurred in 34% (15/44) of the patients. We divided the patients into 2 groups: (1) patients with LVRR (n = 15); (2) patients without LVRR (n = 29). The presence of atrial fibrillation was 40% in patients with LVRR and 14% in those without (p = 0.067). Initial LV end-diastolic dimension was significantly smaller (62 ± 6 vs. 67 ± 6 mm, p = 0.033) in patients with LVRR than in those without. Initial LV end-diastolic dimension of 63.5 mm was an optimal cutoff value for predicting LVRR (sensitivity: 67%, specificity: 59%, area under the curve: 0.70, p = 0.030). When patients were further allocated according to initial LV end-diastolic dimension ≤ 63.5 mm with atrial fibrillation, the combined parameter was a significant predictor of LVRR by univariate logistic regression analysis (odds ratio, 5.78, p = 0.030) (sensitivity: 33%, specificity: 97%, p = 0.013).

CONCLUSIONS:

Combined information on LV end-diastolic dimension and heart rhythm at diagnosis is useful in predicting future LVRR in patients with IDC.

• Authors: Yoshihisa Matsumura, Eri Hoshikawa-Nagai, Toru Kubo, Naohito Yamasaki, Hiroaki Kitaoka, Jun Takata, Yoshinori Doi, Tetsuro Sugiura
• Journal: Cardiovascular ultrasound (Cardiovasc Ultrasound) Vol. 13 Pg. 14 (Mar 25 2015) ISSN: 1476-7120 [Electronic] England
• PMID: 25880063 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors

Topics

• Angiotensin Receptor Antagonists (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Cardiomyopathy, Dilated (diagnostic imaging, drug therapy, physiopathology)
• Echocardiography (methods)
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Recovery of Function (drug effects, physiology)
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Treatment Outcome
• Ventricular Remodeling (drug effects, physiology)