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To determine the prognostic factors of dilated cardiomyopathy (DCM), a retrospective long-term investigation of 111 patients seen between 1967 and 1983 was carried out. Fifty-four deaths were divided into 3 subgroups: (1): sudden death (n = 6); (2): sudden death on the basis of heart failure (n = 17); (3): refractory heart failure death (n = 31). Multivariate analysis was employed to ascertain the prognostic score, which was constructed from the grading of the New York Heart Association functional classification, the cardiothoracic ratio, electrocardiographic findings and cardiac function. Individual variables were indicated on the first (I) and second (II) principal component axes. The mean center points for the death modes were as follows: (1): I = -0.4, II = +0.8, (2): I = +0.7, II = +1.1, (3): I = +1.4, II = -0.8. Surviving cases (n = 57) showed I = -0.6, II = +0.1. Forty-one cases examined during 1984-1985 were analyzed to evaluate the prognostic efficacy of this score. Fourteen of 17 cases (82%) located in the refractory heart failure death group died within one year after determination of the prognosis, showing thereby that the prognostic determination by multivariate analysis is effective.

Prognosis of dilated cardiomyopathy. From a retrospective to a prospective study employing multivariate analysis.