title: The effect of recent advances in pharmacologic management on the prognosis of dilated cardiomyopathy.
abstract: To determine the effect of recent advances in medical management on the survival of patients with dilated cardiomyopathy (DCM), 103 patients with DCM were studied. The subjects were divided into 3 groups based upon the time of initial medical treatment at our institute: Group I, between 1976 and 1981, 20 patients; Group II, between 1982 and 1985, 27 patients; and Group III, between 1986 and 1991, 56 patients. The clinical, Holter electrocardiographic and echocardiographic findings, the pharmacologic treatments used, and the clinical outcomes for the 3 groups of patients were compared. During the follow-up period, which averaged 27 months, 31 deaths related to cardiac disease occurred. The 4 year survival rate was 76% in Group III, 49% in Group II and 35% in Group I; the difference in survival rate between Groups I and III was significant (p < 0.01). At the initial evaluation, no differences were found among the 3 groups in the incidences of advanced heart failure (NYHA functional class III or IV), atrial fibrillation or complex ventricular arrhythmias. Neither diastolic blood pressure nor heart rate differed among the 3 groups, but Group III patients were older and had significantly higher systolic blood pressures than Group I patients (p < 0.05, for both comparisons). There were no differences among the 3 groups in % fractional shortening, left ventricular end-systolic wall stress or left ventricular wall thickness, but left ventricular dimensions were significantly smaller in Group III than in Group I (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: First Department of Internal Medicine, Kobe University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yokota
authors.forename: Y
authors.initials: Y
authors.lastname: Tsumura
authors.forename: A
authors.initials: A
authors.lastname: Takarada
authors.forename: H
authors.initials: H
authors.lastname: Kawai
authors.forename: M
authors.initials: M
authors.lastname: Yokoyama
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000401:mortality; D004071:Digitalis Glycosides / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D004071:Digitalis Glycosides; D004232:Diuretics; D014665:Vasodilator Agents