[Clinical outcome and reversibility of systolic dysfunction in patients with dilated cardiomyopathy due to hypertension and chronic heart failure].
OBJECTIVE
There is little information on the clinical and functional course of patients with heart failure secondary to dilated cardiomyopathy due to hypertension. The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis.


METHODS
We evaluated a series of 49 patients with this condition diagnosed in our hospital from 1994 to 2003. Mean age was 63(11) years, and 40% were women. Left ventricular ejection fraction was 30.1(4.8)%. Follow-up was 45(23) months (median, 41 months).


RESULTS
Four-year survival was 0.84, the 4-year rate of hospitalization due to heart failure was 0.12, and likelihood of readmission-free survival was 0.80 at 4 years. Left ventricular ejection fraction increased from 30.1(4.8)% to 57.6(13.5)% (P< .001). An unfavorable clinical and functional outcome at 4 years (death, readmission for heart failure or persistence of dilated cardiomyopathy) was recorded in only in 40% of the patients. Multivariate analysis with the Cox model showed appropriate control of blood pressure to be the only independent predictor of a favorable clinical outcome (absence of death or readmission for heart failure) (hazard ratio = 4.58; 95% CI, 1.32-9.83; P=.032).


CONCLUSIONS
The course of patients with severe dilated cardiomyopathy due to hypertension was favorable in 60% of cases. Adequate control of blood pressure was the only independent predictor of a favorable clinical outcome.
Anguita Sánchez
Manuel
M
Servicio de Cardiología, Hospital Reina Sofía, Córdoba, Spain. manuelp.anguita.sspa@juntadeandalucia.es
Rodríguez Esteban
Marcos
M
Ojeda Pineda
Soledad
S
Ruiz Ortiz
Martín
M
Romo Peña
Elías
E
Mesa Rubio
Dolores
D
Vallés Belsué
Federico
F
D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D020127:Recovery of Function; D016019:Survival Analysis; D013599:Systole; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy* / Q000401:mortality
D002317:Cardiovascular Agents
Evolución clínica y reversibilidad de la disfunción sistólica en pacientes con miocardiopatía dilatada hipertensiva e insuficiencia cardíaca crónica.