title: Characteristics of syncope in patients with dilated cardiomyopathy.
abstract: BACKGROUND
  Syncope carries a poor prognosis among patients with dilated cardiomyopathy (DCM).
  
  
  OBJECTIVE
  To assess the prevalence, describe the underlying mechanisms and to identify risk factors for syncope in patients with DCM.
  
  
  METHODS
  One thousand six hundred and ten medical files of 897 patients with a diagnosis of DCM were reviewed. Patients with syncope were identified and their clinical and paraclinical profiles were compared to an equal number of age- and sex-matched patients with DCM without syncope.
  
  
  RESULTS
  Thirty patients (27 males) with an average age of 62.5 years were identified, corresponding to a prevalence of syncope of 3.3%. A cardiac origin of syncope was identified in 56% of patients (n=17): ventricular arrhythmias in 33% (n=10), and conduction disorders in 23% (n=7). Other mechanisms of syncope were neurally mediated in 7% (n=2) and orthostatic hypotension in 7% (n=2). In 30% of cases (n=9), the etiology was unidentified. There were no significant differences regarding the etiology of DCM, ejection fraction (35.3% vs 35.3%, p=1.0), NYHA class (mild or advanced, p=0.79) and associated conditions (hypertension, p=0.36; diabetes, p=0.75; atrial fibrillation, p=0.43; and dyslipidemia, p=0.33) between the two groups. However, among patients with syncope, patients with a noncardiac cause were more likely to have hypertension (61.53% vs 23.52%, p=0.08) and diabetes (46.15% vs 5.88%, p=0.03).
  
  
  CONCLUSIONS
  In patients with DCM, syncope is a relatively rare finding. Cardiac causes (arrhythmias and conduction disorders) are responsible for the majority of cases. Risk factors for syncope in these patients remain to be determined.
authors.affiliation: "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.
authors.forename: Abdel-Hadi
authors.initials: AH
authors.lastname: Rami
authors.affiliation: "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania; Rehabilitation Hospital, Cardiology Service, Cluj-Napoca, Cluj, Romania. Electronic address: lmure_san@yahoo.com.
authors.forename: Muresan
authors.initials: M
authors.lastname: Lucian
authors.affiliation: "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania; Rehabilitation Hospital, Cardiology Service, Cluj-Napoca, Cluj, Romania.
authors.forename: Pop
authors.initials: P
authors.lastname: Dana
authors.affiliation: "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania; Rehabilitation Hospital, Cardiology Service, Cluj-Napoca, Cluj, Romania.
authors.forename: Zdrenghea
authors.initials: Z
authors.lastname: Dumitru
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000503:physiopathology; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D013575:Syncope / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology
keywords: Dilated cardiomyopathy; Heart failure; Left ventricular ejection fraction; Syncope