Tags

Type your tag names separated by a space and hit enter

Incidence and predictors of sudden cardiac death during long-term follow-up in patients with dilated cardiomyopathy on optimal medical therapy.
Ital Heart J. 2001 Mar; 2(3):213-21.IH

Abstract

BACKGROUND

In spite of a total mortality reduction in recent years, sudden cardiac death (SD) remains a major problem in patients with idiopathic dilated cardiomyopathy (IDC) and its occurrence is often unpredictable. Furthermore, the risk of SD may change during follow-up because of the natural history of the disease and the effects of therapeutic interventions. In our study, we evaluated the modifications of the risk of SD during follow-up in a cohort of patients with IDC and analyzed the variables predicting SD not only at enrolment but also at the last examination during optimal medical treatment.

METHODS

Since 1978, 343 consecutive patients with IDC were enrolled in the Heart Muscle Disease Registry of Trieste (Italy) and submitted to complete invasive and non-invasive study. Patients were re-evaluated usually at intervals of 12 months.

RESULTS

After a mean of 68+/-45 months, 125 events (death, heart transplantation or aborted SD) had occurred. The cumulative risk after 5 years was 30%, while after 10 years it almost doubled (54%). During the first 3 months after enrolment, the incidence of SD was high (3%). A plateau, lasting about 3.5 years, followed. A slow but progressive rise in the risk of mortality then occurred (6% at 5 years, 18% at 10 years). No variables evaluated at enrolment were associated with SD at multivariate analysis. On the other hand, the end-diastolic left ventricular diameter (> or = 38 mm/m2) and ejection fraction (< or = 0.30) were predictive of SD if evaluated within 1 year before the event. Beta-blocker treatment was associated with a non-significant reduction of risk.

CONCLUSIONS

In patients with IDC the incidence of SD progressively increased during long-term follow-up, especially in those with persistent severe left ventricular dilation and dysfunction who were not on beta-blocker treatment. Serial clinical evaluation may help to select patients at higher risk for SD.

Authors+Show Affiliations

Department of Cardiology, Maggiore Hospital, University of Trieste, Italy. zecchin@adriacom.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11305533

Citation

Zecchin, M, et al. "Incidence and Predictors of Sudden Cardiac Death During Long-term Follow-up in Patients With Dilated Cardiomyopathy On Optimal Medical Therapy." Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, vol. 2, no. 3, 2001, pp. 213-21.
Zecchin M, Lenarda AD, Bonin M, et al. Incidence and predictors of sudden cardiac death during long-term follow-up in patients with dilated cardiomyopathy on optimal medical therapy. Ital Heart J. 2001;2(3):213-21.
Zecchin, M., Lenarda, A. D., Bonin, M., Mazzone, C., Zanchi, C., Di Chiara, C., Davanzo, M., Scherl, G., Sabbadini, G., & Sinagra, G. (2001). Incidence and predictors of sudden cardiac death during long-term follow-up in patients with dilated cardiomyopathy on optimal medical therapy. Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, 2(3), 213-21.
Zecchin M, et al. Incidence and Predictors of Sudden Cardiac Death During Long-term Follow-up in Patients With Dilated Cardiomyopathy On Optimal Medical Therapy. Ital Heart J. 2001;2(3):213-21. PubMed PMID: 11305533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and predictors of sudden cardiac death during long-term follow-up in patients with dilated cardiomyopathy on optimal medical therapy. AU - Zecchin,M, AU - Lenarda,A D, AU - Bonin,M, AU - Mazzone,C, AU - Zanchi,C, AU - Di Chiara,C, AU - Davanzo,M, AU - Scherl,G, AU - Sabbadini,G, AU - Sinagra,G, PY - 2001/4/18/pubmed PY - 2001/8/31/medline PY - 2001/4/18/entrez SP - 213 EP - 21 JF - Italian heart journal : official journal of the Italian Federation of Cardiology JO - Ital Heart J VL - 2 IS - 3 N2 - BACKGROUND: In spite of a total mortality reduction in recent years, sudden cardiac death (SD) remains a major problem in patients with idiopathic dilated cardiomyopathy (IDC) and its occurrence is often unpredictable. Furthermore, the risk of SD may change during follow-up because of the natural history of the disease and the effects of therapeutic interventions. In our study, we evaluated the modifications of the risk of SD during follow-up in a cohort of patients with IDC and analyzed the variables predicting SD not only at enrolment but also at the last examination during optimal medical treatment. METHODS: Since 1978, 343 consecutive patients with IDC were enrolled in the Heart Muscle Disease Registry of Trieste (Italy) and submitted to complete invasive and non-invasive study. Patients were re-evaluated usually at intervals of 12 months. RESULTS: After a mean of 68+/-45 months, 125 events (death, heart transplantation or aborted SD) had occurred. The cumulative risk after 5 years was 30%, while after 10 years it almost doubled (54%). During the first 3 months after enrolment, the incidence of SD was high (3%). A plateau, lasting about 3.5 years, followed. A slow but progressive rise in the risk of mortality then occurred (6% at 5 years, 18% at 10 years). No variables evaluated at enrolment were associated with SD at multivariate analysis. On the other hand, the end-diastolic left ventricular diameter (> or = 38 mm/m2) and ejection fraction (< or = 0.30) were predictive of SD if evaluated within 1 year before the event. Beta-blocker treatment was associated with a non-significant reduction of risk. CONCLUSIONS: In patients with IDC the incidence of SD progressively increased during long-term follow-up, especially in those with persistent severe left ventricular dilation and dysfunction who were not on beta-blocker treatment. Serial clinical evaluation may help to select patients at higher risk for SD. SN - 1129-471X UR - https://www.unboundmedicine.com/medline/citation/11305533/Incidence_and_predictors_of_sudden_cardiac_death_during_long_term_follow_up_in_patients_with_dilated_cardiomyopathy_on_optimal_medical_therapy_ L2 - http://www.diseaseinfosearch.org/result/2284 DB - PRIME DP - Unbound Medicine ER -