title: Early vs. late reverse ventricular remodeling in patients with cardiomyopathy.
abstract: Predictors of left ventricular reverse remodeling (LVRR) and differences in the time taken to achieve LVRR remain unclear.
  
  
  
  We consecutively registered 129 patients with severe cardiomyopathy admitted with heart failure (HF). Patients were followed for a median of 778.0 days (IQ: 457.0, 1078.0). LVRR was defined as a decrease in indexed left ventricular systolic dimension of at least 15% additional to a 25% improvement in left ventricular ejection fraction at outpatient check-up compared with discharge. LVRR accomplishment within 400 days was defined as early-LVRR opposing the remaining late-LVRR patients. Primary endpoint was a composite of all-cause mortality and HF re-hospitalization.
  
  
  
  LVRR was observed in 51 patients (39.5%). Baseline predictors for LVRR were age younger than 60 years (OR, 3.27; 95% CI 1.04-10.37, p=0.043), no history of previous HF hospitalization (OR, 0.32; 95% CI 0.12-0.86, p=0.025), and systolic blood pressure (sBP) >100mmHg at discharge (OR, 4.39; 95% CI 1.39-13.81, p=0.011). Overall, there were 51 endpoint events [LVRR 11 (21.6%) vs. non-LVRR 40 (49.4%), p<0.001]. LVRR was a significant predictor of favorable prognosis (HR, 3.77; 95% CI 1.68-8.47, p<0.001). Notably, 41 (80.4%) patients qualified for early-LVRR. Early-LVRR was associated with better prognosis compared with late-LVRR [early-LVRR 6 (14.6%) vs. late-LVRR 5 (50.0%), p=0.066]. Among assessed variables, sBP >100mmHg at discharge was a significant predictor of early-LVRR (OR, 10.87; 95% CI 1.19-100.0, p=0.034).
  
  
  
  Prognosis was improved in patients who achieved LVRR. Early-LVRR tended to be an advantage in terms of long-term prognosis. Higher sBP was a predictor not only for all-LVRR but also early-LVRR.
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Banno
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: kohsaka@cpnet.med.keio.ac.jp.
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Inohara
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kimi
authors.initials: K
authors.lastname: Koide
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Shiraishi
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kohno
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Sano
authors.affiliation: Division of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Division of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000368:Aged; D001794:Blood Pressure; D009202:Cardiomyopathies / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
keywords: Blood pressure; Cardiomyopathy; Predictors; Reverse remodeling