[Follow-up of patients with minor grades of dilated cardiomyopathy].

It is not known whether dilated cardiomyopathy (DCM) with a slight reduction of left ventricular contractions represents an "early form" and is liable to deterioration. 29 patients (mean age 45 +/- 10 years; 66% women) with mild DCM (angiographic ejection fraction between 50 and 60%, mean 56 +/- 3%) were prospectively studied for 4.0 +/- 1.7 years. No patients died. Comparing the beginning of this study (I) with its end (II) the mean clinical class (I 2.0 +/- 0.4, II 2.0 +/- 0.4), cardio-thoracic ratio (I 0.48 +/- 0.05, II 0.47 +/- 0.04), the end-diastolic diameter of the left ventricle (I 52.2 +/- 6.2 mm, II 53.0 +/- 5.2 mm) and fractional shortening in M-Mode echocardiography (I 28.3 +/- 6.8%, II 29.4 +/- 7.1%) remained unchanged. Compared to the angiographic ejection fraction at the start of the study, this parameter was slightly reduced in the final examination by 2-dimensional echocardiography (46 +/- 7%). One patient with definite echocardiographic and clinical deterioration showed from the outset a distinct increase in end-diastolic size of the left ventricle. Four patients with improvement in M-Mode parameters did not fundamentally differ from the rest of the patients. Our results indicate that a slight reduction in contractions rarely deteriorates further, and should thus not always be considered as an early form of DCM.