School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Cardiol. 2023 Jun;46(6):674-679. doi: 10.1002/clc.24022. Epub 2023 Apr 14.
Patients with nonischemic dilated cardiomyopathy (DCM) are susceptible to arrhythmias and implantable cardioverter defibrillator (ICD) in addition to medical treatments may help prevent sudden cardiac death (SCD) and improve survival in this population.
We aim to investigate the impact of ICD insertion on survival and prognosis of patients with nonischemic DCM.
We retrospectively analyzed data from patients with nonischemic DCM treated with medical therapy with or without ICD who referred to our hospital from January 2020 to November 2021. Patients were divided based on the treatment that they had received into two equal groups. Different variables including demographic features, comorbidities, medical treatments, hospitalization rate, function class, and left ventricular ejection fraction before and after treatments were investigated in this study. In addition, variables in survival including overall survival (OS) and SCD were compared between the two groups.
A total of 120 patients were investigated in this study. Mean ± SD of age and follow-up time of patients were 64.0 ± 12.7 years old and 61.2 ± 15.9 months, respectively. Ten (16.7%) patients with medical therapy, and seven (11.7%) patients with ICD and medical therapy died during the follow-up period (p = 0.25). However, the two groups had a significant difference regarding SCD (11.7% vs. 1.7%, p = 0.02).
In patients with nonischemic DCM who had undergone ICD insertion in addition to standard medical treatments, SCD was significantly reduced compared with patients receiving just medical treatments. OS had no significant difference between our two studied groups.
非缺血性扩张型心肌病（DCM）患者除了接受药物治疗外，还容易发生心律失常和植入式心脏复律除颤器（ICD），此外，ICD 可能有助于预防心脏性猝死（SCD）并改善该人群的生存率。
我们旨在研究 ICD 植入对非缺血性 DCM 患者生存和预后的影响。
我们回顾性分析了 2020 年 1 月至 2021 年 11 月期间因非缺血性 DCM 接受药物治疗加或不加 ICD 治疗的患者的数据。根据患者接受的治疗方法将患者分为两组。本研究调查了不同的变量，包括人口统计学特征、合并症、药物治疗、住院率、功能分级和治疗前后的左心室射血分数。此外，比较了两组患者的生存变量，包括总生存率（OS）和 SCD。
本研究共纳入 120 例患者。患者的平均年龄和随访时间分别为 64.0±12.7 岁和 61.2±15.9 个月。在随访期间，10 名（16.7%）接受药物治疗的患者和 7 名（11.7%）接受 ICD 和药物治疗的患者死亡（p=0.25）。然而，两组患者的 SCD 发生率有显著差异（11.7%比 1.7%，p=0.02）。
与仅接受药物治疗的患者相比，在接受 ICD 植入加标准药物治疗的非缺血性 DCM 患者中，SCD 显著降低。两组患者的 OS 无显著差异。
