Please use this identifier to cite or link to this item:
Title: Clinical Determinants and Prognosis of Left Ventricular Reverse Remodelling in Non-Ischemic Dilated Cardiomyopathy
Author: Díez López, Carles
Salazar Mendiguchía, Joel
García Romero, Elena
Fuentes, Lara
Lupón, Josep
Bayés Genís, Antoni
Manito Lorite, Nicolás
Antonio, Marta de
Moliner, Pedro
Zamora, Elisabet
Catalá Ruíz, Pablo
Caínzos Achirica, Miguel
Comín Colet, Josep
González Costello, José
Keywords: Insuficiència cardíaca
Pronòstic mèdic
Heart failure
Issue Date: 11-Jan-2022
Publisher: MDPI AG
Abstract: Aims: Non-ischaemic dilated cardiomyopathy (NIDCM) is characterized by left ventricular (LV) chamber enlargement and systolic dysfunction in the absence of coronary artery disease. Left ventricular reverse remodelling (LVRR) is the ability of a dilated ventricle to restore its normal size, shape and function. We sought to determine the frequency, clinical predictors and prognostic implications of LVRR, in a cohort of heart failure (HF) patients with NIDCM. Methods: We conducted a multicentre observational, retrospective cohort study of patients with NIDCM, with prospective serial echocardiography evaluations. LVRR was defined as an increase of >= 15% in left ventricular ejection fraction (LVEF) or as a LVEF increase >= 10% plus reduction of LV end-systolic diameter index >= 20%. We used multivariable logistic regression analyses to identify the baseline clinical predictors of LVRR and evaluate the prognostic impact of LVRR. Results: LVRR was achieved in 42.5% of 527 patients with NIDCM during the first year of follow-up (median LVEF 49%, median change +22%), Alcoholic aetiology, HF duration, baseline LVEF and the absence of LBBB (plus NT-proBNP levels when in the model), were the strongest predictors of LVRR. During a median follow-up of 47 months, 134 patients died (25.4%) and 7 patients (1.3%) received a heart transplant. Patients with LVRR presented better outcomes, regardless of other clinical conditions. Conclusions: In patients with NIDCM, LVRR was frequent and was associated with improved prognosis. Major clinical predictors of LVRR were alcoholic cardiomyopathy, absence of LBBB, shorter HF duration, and lower baseline LVEF and NT-proBNP levels. Our study advocates for clinical phenotyping of non-ischaemic dilated cardiomyopathy and intense gold-standard treatment optimization of patients according to current guidelines and recommendations in specialized HF units.
Note: Reproducció del document publicat a:
It is part of: Journal of Cardiovascular Development and Disease, 2022, vol 9, num 1
Related resource:
ISSN: 2308-3425
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Files in This Item:
File Description SizeFormat 
jcdd-09-00020-v3.pdf535.95 kBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons