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Influence of different aetiologies on clinical course and outcome in patients with dilated cardiomyopathy
Author(s) -
Pankuweit Sabine,
Lüers Claus,
Richter Anette,
Ruppert Volker,
Gelbrich Götz,
Maisch Bernhard
Publication year - 2015
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12483
Subject(s) - medicine , dilated cardiomyopathy , ejection fraction , heart failure , cardiology , cardiomyopathy , myocarditis , etiology
Background The clinical phenotype dilated cardiomyopathy is assumed to be the endstage of a multifactorial aetiopathogenetic pathophysiology which includes a not satisfactorily defined group of patients with inflammatory cardiomyopathy. Methods Within the German Competence Network Heart Failure patients with heart failure due to dilated cardiomyopathy of viral/inflammatory ( DCM i/v) and nonviral/noninflammatory ( DCM ) aetiology were enrolled. After 1 year 237 patients (180 male/57 female) were re‐examined including complete clinical work‐up. The association of different clinical courses with the time from initial diagnosis of heart failure (newly: ≤ 1 year; late: > 1 year) was investigated. Results After 1‐year‐follow‐up New York Heart Association ( NYHA ) class (by −0·48 in newly diagnosed DCM and −0·82 in newly diagnosed DCM i/v in addition to −0·24 in late diagnosed DCM and −0·17 in late diagnosed DCM i/v) as well as left ventricular ejection fraction (+14% in newly diagnosed DCM and DCM i/v and +6% in later diagnosed DCM and DCM i/v) were significantly improved in all patients. In patients with early diagnosed dilated cardiomyopathy a strong improvement of NYHA class could be demonstrated. Conclusions This study demonstrates for the first time a significant interaction between duration of disease, NYHA class and left ventricular ejection fraction in patients with DCM . Our results clearly demonstrate that in patients with DCM an early diagnosis within 1 year after occurrence of clinical signs is associated with a strong improvement in the clinical course, whereas late diagnosis results in a loss of change in clinical course and outcome.