Maire R, Hess O M, Turina J, Greminger P, Krayenbühl H P
Schweiz Med Wochenschr. 1985 Nov 9;115(45):1609-12.
Between 1969 and 1984, 68 patients with dilated cardiomyopathy (mean age 44 years) were observed for an average period of 45 months. 46 patients (68%) died (17 sudden death, 13 congestive heart failure, 5 other causes and 11 unknown causes) during the observation period according to a cumulative 5-year survival rate of 40%. All patients underwent diagnostic cardiac catheterization. Left ventricular ejection fraction was 32%, left ventricular end-diastolic volume index 195 ml/m2, left ventricular end-diastolic pressure 17 mm Hg and cardiac index 2.7 l/min/m2. The initial hemodynamic findings in the non-survivors and the survivors were statistically not significantly different. The prognostic significance of 12 clinical and hemodynamic parameters was evaluated by multivariate regression analysis (Cox model). Only 3 hemodynamic parameters, namely left ventricular end-diastolic volume, left ventricular end-diastolic pressure and cardiac index, showed prognostic significance in regard to survival. Prognostic evaluation of medical therapy (antiarrhythmic drugs n = 14, vasodilators n = 17, anticoagulation n = 37) revealed an improved cumulative 3-year survival rate (87% versus 46%) only for vasodilators.
1969年至1984年间，对68例扩张型心肌病患者（平均年龄44岁）进行了平均45个月的观察。根据40%的5年累积生存率，46例患者（68%）在观察期内死亡（17例猝死，13例死于充血性心力衰竭，5例死于其他原因，11例死因不明）。所有患者均接受了诊断性心导管检查。左心室射血分数为32%，左心室舒张末期容积指数为195 ml/m²，左心室舒张末期压力为17 mmHg，心脏指数为2.7 l/min/m²。非幸存者和幸存者的初始血流动力学结果在统计学上无显著差异。通过多因素回归分析（Cox模型）评估了12项临床和血流动力学参数的预后意义。只有3项血流动力学参数，即左心室舒张末期容积、左心室舒张末期压力和心脏指数，在生存方面显示出预后意义。药物治疗（抗心律失常药物14例，血管扩张剂17例，抗凝剂37例）的预后评估显示，仅血管扩张剂可提高3年累积生存率（87%对46%）。
