Prevalence and clinical predictors of reverse remodeling in patients with dilated cardiomyopathy

Michael Arad, Tamar Nussbaum, Ido Blechman, Micha S. Feinberg, Nira Koren-Morag, Yael Peled, Dov Freimark

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Contemporary therapies improve prognosis and may restore left ventricular (LV) size and function. Objectives: To examine the prevalence, clinical features and therapies associated with reverse remodeling (RR) in dilated cardiomyopathy (DCM). Methods: The study group comprised 188 DCM patients who had undergone two echo examinations at least 6 months apart. RR was defined as increased LV ejection fraction (LVEF) by ≥ 10% concomitant with ≥ 10% decreased LV end-diastolic dimension. Results: RR occurred in 50 patients (26%) and was associated with significantly reduced end-systolic dimension, left atrial size, grade of mitral regurgitation, and pulmonary artery pressure. NYHA class improved in the RR group. RR was less common in familial DCM and a long-standing disease and was more prevalent in patients with prior exposure to chemotherapy. Recent-onset disease, lower initial LVEF and normal electrocardiogram were identified as independent predictors of RR. Beta-blocker dose was related to improved LVEF but not to RR. Over a mean follow-up of 23 months, 16 patients (12%) from the 'no-RR' group died or underwent heart transplantation compared to none from the RR group (P< 0.01). Conclusions: Contemporary therapies led to an an improvement in the condition of a considerable number of DCM patients. A period of close observation while optimizing medical therapy should be considered before deciding on invasive procedures.

Original languageEnglish
Pages (from-to)405-411
Number of pages7
JournalIsrael Medical Association Journal
Volume16
Issue number7
StatePublished - Jul 2014
Externally publishedYes

Keywords

  • Cardiomyopathy
  • Echocardiography
  • Electrocardiography (ECG)
  • Heart failure
  • Reverse Remodeling (RR)

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