title: Prediction of left ventricular reverse remodeling after therapy with angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and β blockers in patients with idiopathic dilated cardiomyopathy.
abstract: BACKGROUND
  Predictors of left ventricular reverse remodeling (LVRR) after therapy with angiotensin converting enzyme inhibitors or angiotensin-receptor blockers and β blockers in patients with idiopathic dilated cardiomyopathy (IDC) remains unclear.
  
  
  METHODS
  We studied 44 patients with IDC who had been treated with the therapy. LVRR was defined as LV end-diastolic dimension ≤ 55 mm and fractional shortening ≥ 25% at the last echocardiogram.
  
  
  RESULTS
  During a mean follow-up period of 4.7 ± 3.3 years, LVRR occurred in 34% (15/44) of the patients. We divided the patients into 2 groups: (1) patients with LVRR (n = 15); (2) patients without LVRR (n = 29). The presence of atrial fibrillation was 40% in patients with LVRR and 14% in those without (p = 0.067). Initial LV end-diastolic dimension was significantly smaller (62 ± 6 vs. 67 ± 6 mm, p = 0.033) in patients with LVRR than in those without. Initial LV end-diastolic dimension of 63.5 mm was an optimal cutoff value for predicting LVRR (sensitivity: 67%, specificity: 59%, area under the curve: 0.70, p = 0.030). When patients were further allocated according to initial LV end-diastolic dimension ≤ 63.5 mm with atrial fibrillation, the combined parameter was a significant predictor of LVRR by univariate logistic regression analysis (odds ratio, 5.78, p = 0.030) (sensitivity: 33%, specificity: 97%, p = 0.013).
  
  
  CONCLUSIONS
  Combined information on LV end-diastolic dimension and heart rhythm at diagnosis is useful in predicting future LVRR in patients with IDC.
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi University, Nankoku-shi, Kochi, Oko-cho, 783-8505, Japan. matsumur@kochi-u.ac.jp.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Cardiology, Neurology, and Aging Science, Kochi Medical School, Kochi University, Kochi, Japan. hoshi_bar@yahoo.co.jp.
authors.forename: Eri
authors.initials: E
authors.lastname: Hoshikawa-Nagai
authors.affiliation: Department of Cardiology, Neurology, and Aging Science, Kochi Medical School, Kochi University, Kochi, Japan. jm-kubotoru@kochi-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Cardiology, Neurology, and Aging Science, Kochi Medical School, Kochi University, Kochi, Japan. yamasakn@kochi-u.ac.jp.
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.affiliation: Department of Cardiology, Neurology, and Aging Science, Kochi Medical School, Kochi University, Kochi, Japan. kitaokah@kochi-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.affiliation: Center to Promote Creativity in Medical Education, Kochi Medical School, Kochi University, Kochi, Japan. taka905@kochi-u.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Takata
authors.affiliation: Chikamori Hospital, Kochi, Japan. ydoi@chikamori.com.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Doi
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi University, Nankoku-shi, Kochi, Oko-cho, 783-8505, Japan. sugiurat@kochi-u.ac.jp.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function / Q000187:drug effects / Q000502:physiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000187:drug effects* / Q000502:physiology
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors