title: [Clinical outcome and reversibility of systolic dysfunction in patients with dilated cardiomyopathy due to hypertension and chronic heart failure].
abstract: 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.
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Córdoba, Spain. manuelp.anguita.sspa@juntadeandalucia.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Anguita Sánchez
authors.forename: Marcos
authors.initials: M
authors.lastname: Rodríguez Esteban
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda Pineda
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz Ortiz
authors.forename: Elías
authors.initials: E
authors.lastname: Romo Peña
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa Rubio
authors.forename: Federico
authors.initials: F
authors.lastname: Vallés Belsué
mesh_terms: 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
chemical_list: D002317:Cardiovascular Agents
vernacular_title: Evolución clínica y reversibilidad de la disfunción sistólica en pacientes con miocardiopatía dilatada hipertensiva e insuficiencia cardíaca crónica.