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Myocardial Contractile Reserve as Prognostic Determinant in Patients With Idiopathic Dilated Cardiomyopathy Without Overt Heart Failure

Hideki Nagaoka; Naoki Isobe; Sachio Kubota; Susumu Imai; Ryozo Nagai; Tadashi Suzuki; Toshio Iizuka
Author and Funding Information

Affiliations: From the Second Department of Internal Medicine, Gunma University School of Medicine, Gunma, Japan,  From the College of Medical Care and Technology, Gunma University School of Medicine, Gunma, Japan,  From the Department of Internal Medicine, Tano General Hospital, Gunma, Japan

Affiliations: From the Second Department of Internal Medicine, Gunma University School of Medicine, Gunma, Japan,  From the College of Medical Care and Technology, Gunma University School of Medicine, Gunma, Japan,  From the Department of Internal Medicine, Tano General Hospital, Gunma, Japan

Affiliations: From the Second Department of Internal Medicine, Gunma University School of Medicine, Gunma, Japan,  From the College of Medical Care and Technology, Gunma University School of Medicine, Gunma, Japan,  From the Department of Internal Medicine, Tano General Hospital, Gunma, Japan


1997 by the American College of Chest Physicians


Chest. 1997;111(2):344-350. doi:10.1378/chest.111.2.344
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Abstract

To assess the prognostic significance of myocardial contractile reserve in patients with idiopathic dilated cardiomyopathy (DCM) without overt heart failure (New York Heart Association functional class I or II), seventy-one patients underwent exercise radionuclide angiography in addition to clinical, radiographic, hemodynamic, and echocardiographic evaluations. Myocardial contractile reserve was assessed as left ventricular ejection fraction (LVEF) during peak exercise minus LVEF at rest (ΔLVEF). During an average of 49 months, 18 patients died of the disease. Cox's proportional-hazards regression analysis showed that the ΔLVEF was the most powerful and independent discriminator for survival (p=0.0002). Ejection time (p=0.0029) and cardiothoracic ratio (p=0.017) were the second and third most predictive variables, respectively. Evaluation of the ΔLVEF, which reflects residual myocardial contractile reserve, can provide important information about the prognosis of patients with DCM and mild symptoms.


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