Prognosis of dilated cardiomyopathy. An integrated analysis including endomyocardial biopsy findings.

A long-term prognostic study of up to 15 years of dilated cardiomyopathy (DCM) was carried out in 65 cases. The 5-year survival rate after the onset of subjective symptoms was 40%, and the 10-year survival rate 22%. To evaluate the prognostic factor of DCM, the cardiothoracic ratio (CTR), ECG, hemodynamics, and histopathological contractility failure index (HCFI), which we constructed through right ventricular endomyocardial biopsy, were compared. Patients having malignant arrhythmias, such as short runs or multifocal ventricular premature beats with mild impaired cardiac status, mild cardiomegaly, and low HCFI, were more prone to sudden death. In patients with progressively deteriorating cardiac status, refractory cardiomegaly, supraventricular arrhythmias, left axis deviation, prolongation of QRS interval, low voltage, and high HCFI, the cause of death is more likely to be refractory heart failure.