Ventricular long axis function is predictive of outcome in patients with chronic heart failure secondary to non-ischemic dilated cardiomyopathy.
BACKGROUND
Ventricular long axis function has recently been proved to be of prognostic value in patients with heart failure. However, it remains unclear whether it can provide additional independent information over that provided by conventionally used LVEF or functional status. We conducted this study to address this issue, and to determine the prognostic importance of sequential change in long axis function over time in patients with idiopathic DCM.


METHODS
We prospectively followed up 299 DCM patients with mean age of 55.5 years and LVEF of 41%. All patients underwent a complete clinical and echocardiographic evaluation including ventricular long axis function at baseline, 1- and 2-year follow-up.


RESULTS
At the end of study, 50 patients died and 6 underwent cardiac transplantation. The majority of deaths occurred before the second examination. In univariate analysis, the absolute values of RV and LV long axis functions at the second examination were significantly related to mortality. In multivariate regression model, they did not maintain their prognostic values. However, a sequential increase in the LV long axis function significantly predicted prognosis, independently of age, NYHA class, and exercise tolerance. The subsequent survival of patients with increased LV long axis function was significantly better than those with either a decrease or no change in it.


CONCLUSIONS
This study clearly indicates that the sequential increase of long axis function was related to significantly better survival in idiopathic DCM patients, which provides a novel method to estimate prognosis of these patients with moderate impairment of LVEF at initial presentation.
Faris
Rajaa
R
Department of Clinical Cardiology, National Heart & Lung Institute, The Royal Brompton Hospital, Dovehouse Street, London SW3 6LY, U.K. rajaa_faris18@hotmail.com
Henein
Michael Y
MY
Coats
Andrew J S
AJ
D002311:Cardiomyopathy, Dilated / Q000473:pathology*; D004452:Echocardiography / Q000379:methods; D006333:Heart Failure / Q000473:pathology*; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left