[Factors to determine the survival of idiopathic dilated cardiomyopathy--selecting candidates for cardiac transplantation].
A long-term follow-up study was carried out in 110 cases of dilated cardiomyopathy (DCM). The 3-year survival rate after diagnosis was 78%, and the 5-year rate was 62%. During this follow-up period (mean 2.8 years), 13 (45%) patients died of CHF, 15 (52%) were lost suddenly without CHF, and one patient died of non-cardiac cause. No patient with CHF survived more than 6 months. To investigate the factors influencing the survival in DCM, the NYHA classification, CTR in chest X-ray, various parameters of chamber structure and cardiac function documented by echocardiogram, ambulatory ECG, hemodynamic data and endomyocardial biopsy findings were examined by Kaplan-Meier's survival curve and tested by generalized Wilcoxon analysis. The important factors were: 1) LVEDVI, 2) diameter of cardiac muscle cell, and 3) occurrence of sustained VT. The 3-year survival rates with respect to these 3 factors were: 66% in patients with more than 150 ml/m2 in LVEDVI (p less than 0.01), 42% in patients with a cardiac muscle cell diameter of more than 25 microns (p less than 0.05) and 32% in those with occurrence of sustained VT (p less than 0.01). Thus, the patients that showed these factors at the initial examination were considered to be candidates for cardiac transplantation, because they were expected to have much better survival.
Otsuka
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000401:mortality*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors