title: Left ventricular reverse remodeling in long-term (>12 years) survivors with idiopathic dilated cardiomyopathy.
abstract: Little is known about left ventricular (LV) reverse remodeling (LVRR) in long-term survivors with idiopathic dilated cardiomyopathy. We studied 59 patients with idiopathic dilated cardiomyopathy who had a potential clinical and echocardiographic follow-up period of >12 years. LVRR was defined as LV end-diastolic dimension ≤ 55 mm and fractional shortening ≥ 25% on the last echocardiogram. Of the 59 patients, 38 died (heart failure in 20, sudden death in 11, and other causes in 7), 2 underwent transplantation, and 19 survived. In the survivors, the LV size had significantly decreased and LV fractional shortening had significantly increased on the last echocardiogram. LVRR occurred in 37% of the survivors. The remaining 63% of the survivors still had LV dysfunction, but the LV end-systolic dimension had decreased significantly. In patients who died or underwent transplantation, the LV size significantly increased. No patient who died or underwent transplantation had LVRR. In conclusion, >60% of the long-term (>12 years) survivors with idiopathic dilated cardiomyopathy still had LV systolic dysfunction, but the LV end-systolic dimension had decreased significantly. In contrast, patients who died or underwent transplantation had significant LV enlargement. These results suggest that LVRR, even if it is not marked, is associated with a favorable prognosis.
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Kochi University, Kochi, Japan. matsumur@kochi-u.ac.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Eri
authors.initials: E
authors.lastname: Hoshikawa-Nagai
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Furuno
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.forename: Jun
authors.initials: J
authors.lastname: Takata
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Doi
mesh_terms: D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*