Frequency and Predictors of Normalization of Left Ventricular Ejection Fraction in Recent-Onset Nonischemic Cardiomyopathy

Emerging evidence has shown the potential of marked improvement in left ventricular ejection fraction (LVEF) in patients with recent-onset cardiomyopathy (ROCM) on medical therapy. This study was designed to determine the frequency and to identify predictors of normalization of LVEF in a cohort of C...

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Bibliographic Details
Published in:The American journal of cardiology 2014-05, Vol.113 (10), p.1705-1710
Main Authors: Zou, Chang-hong, MM, Zhang, Jian, MD, Zhang, Yu-hui, MD, Wei, Bing-qi, MD, Wu, Xue-fei, MB, Zhou, Qiong, MD, Huang, Yan, MB, Zhang, Rong-cheng, MM, Lv, Rong, RN
Format: Article
Language:English
Subjects:
Adult
Alcohol use
Cardiology
Cardiomyopathies - diagnostic imaging
Cardiomyopathies - physiopathology
Cardiomyopathy
Cardiovascular
Cardiovascular disease
China
Confidence intervals
Drug therapy
Echocardiography
Female
Follow-Up Studies
Heart attacks
Heart failure
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humans
Hypertension
Male
Medical prognosis
Multivariate analysis
Prognosis
Recovery of Function
Retrospective Studies
Stroke Volume - physiology
Variables
Ventricular Function, Left - physiology
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Summary:Emerging evidence has shown the potential of marked improvement in left ventricular ejection fraction (LVEF) in patients with recent-onset cardiomyopathy (ROCM) on medical therapy. This study was designed to determine the frequency and to identify predictors of normalization of LVEF in a cohort of Chinese patients with ROCM receiving contemporary medication. A consecutive series of patients admitted from October 2008 to November 2012 with the clinical diagnosis of ROCM and LVEF ≤40% by echocardiography at presentation were followed up at least 12 months to identify those with normalization of LVEF, defined as an increase in LVEF to a final level of ≥50%. An array of clinical and echocardiographic variables regarded as potentially relevant to normalization was evaluated to identify predictors using logistic regression analysis. After a mean follow-up of 31 ± 13 months, 48% of 128 patients had normalized their LVEF, showing a significant increase in LVEF from 32 ± 6% to 58 ± 5%, of which 68% occurred within 1 year after initial diagnosis. Multivariate analysis demonstrated that normalization of LVEF was associated with a history of hypertension, higher systolic blood pressure at presentation, shorter electrocardiographic QRS duration, smaller left ventricular end-diastolic diameter, and higher LVEF by echocardiography at baseline. In conclusion, nearly 1/2 of a relatively large number of Chinese patients with ROCM have shown normalization of LVEF on current medical therapy after a medium-term follow-up, which was associated with some clinical and echocardiographic parameters.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2014.02.028