Zou Changhong, Wu Xuefei, Zhou Qiong, Zhang Yuhui, Lyu Rong, Zhang Jian
Heart Failure Care Unit, Heart Failure Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
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Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Oct;42(10):851-5.
To observe the frequency and predictors of recovery of normal left ventricular ejection fraction (LVEF) and end-diastolic diameter (LVEDD) in patients with dilated cardiomyopathy (DCM).
A consecutive cohort of 296 patients with DCM were reviewed and followed up for at least 12 months or to death or cardiac transplantation, to identify those with recovery of normal LVEF, defined as LVEF ≥ 50%, or recovery of normal LVEDD, defined as LVEDD ≤ 55/50 mm for male/female, or both by follow up echocardiography.Variables regarded as potentially relevant to left ventricular function and dimension recovery were evaluated to identify predictors using multivariable logistic regression analysis.
After a median follow-up of 28 months, normal LVEF was evidenced in 81 patients (27.4%), normal LVEDD was found in 63 patients (21.3%) and both parameters were recovered in 52 patients (17.6%), LVEF was increased from (31.7 ± 6.3)% to ( 57.5 ± 5.2)% (P < 0.01) and LVEDD decreased from (62.7 ± 4.3) mm to (50.2 ± 3.7) mm (P < 0.01) in these 52 patients. Multivariable logistic regression analysis showed that shorter symptom duration, higher systolic blood pressure at admission, smaller LVEDD and lower LVEF by echocardiography at baseline were independent predictors of subsequent recovery of normal LVEF and LVEDD.
Current therapy for heart failure could lead to recovery of normal LVEF and LVEDD in part of DCM patients, especially for DCM patients with short symptom duration, higher systolic blood pressure at admission, less enlarged LVEDD and less reduced LVEF at baseline echocardiography.
观察扩张型心肌病（DCM）患者左心室射血分数（LVEF）和舒张末期内径（LVEDD）恢复正常的频率及预测因素。
对连续入选的296例DCM患者进行回顾性研究，并随访至少12个月或直至死亡或接受心脏移植，通过随访超声心动图确定LVEF恢复正常（定义为LVEF≥50%）、LVEDD恢复正常（男性定义为LVEDD≤55mm，女性定义为LVEDD≤50mm）或两者均恢复正常的患者。评估被认为可能与左心室功能和内径恢复相关的变量，采用多变量逻辑回归分析确定预测因素。
中位随访28个月后，81例患者（27.4%）LVEF恢复正常，63例患者（21.3%）LVEDD恢复正常，52例患者（17.6%）两项指标均恢复正常。这52例患者的LVEF从（31.7±6.3）%增至（57.5±5.2）%（P<0.01），LVEDD从（62.7±4.3）mm降至（50.2±3.7）mm（P<0.01）。多变量逻辑回归分析显示，症状持续时间较短、入院时收缩压较高、基线时LVEDD较小以及超声心动图显示的LVEF较低是随后LVEF和LVEDD恢复正常的独立预测因素。
目前的心力衰竭治疗可使部分DCM患者的LVEF和LVEDD恢复正常，尤其是症状持续时间短、入院时收缩压较高、基线超声心动图显示LVEDD扩大程度较小且LVEF降低程度较小的DCM患者。
