Clinical Outcome and Reversibility of Systolic Dysfunction in Patients With Dilated Cardiomyopathy Due to Hypertension and Chronic Heart Failure

There is little information on the clinical and functional course of patients with heart failure secondary to dilated cardiomyopathy due to hypertension. The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis....

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Veröffentlicht in:Revista española de cardiologia 2004-09, Vol.57 (9), p.834-841
Hauptverfasser: Anguita Sánchez, Manuel, Rodríguez Esteban, Marcos, Ojeda Pineda, Soledad, Ruiz Ortiz, Martín, Romo Peña, Elías, Mesa Rubio, Dolores, Vallés Belsué, Federico
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container_issue 9
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container_title Revista española de cardiologia
container_volume 57
creator Anguita Sánchez, Manuel
Rodríguez Esteban, Marcos
Ojeda Pineda, Soledad
Ruiz Ortiz, Martín
Romo Peña, Elías
Mesa Rubio, Dolores
Vallés Belsué, Federico
description There is little information on the clinical and functional course of patients with heart failure secondary to dilated cardiomyopathy due to hypertension. The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis. We evaluated a series of 49 patients with this condition diagnosed in our hospital from 1994 to 2003. Mean age was 63 (11) years, and 40% were women. Left ventricular ejection fraction was 30.1 (4.8)%. Follow-up was 45 (23) months (median, 41 months). Four-year survival was 0.84, the 4-year rate of hospitalization due to heart failure was 0.12, and likelihood of readmission-free survival was 0.80 at 4 years. Left ventricular ejection fraction increased from 30.1 (4.8)% to 57.6 (13.5)% ( P
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The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis. We evaluated a series of 49 patients with this condition diagnosed in our hospital from 1994 to 2003. Mean age was 63 (11) years, and 40% were women. Left ventricular ejection fraction was 30.1 (4.8)%. Follow-up was 45 (23) months (median, 41 months). Four-year survival was 0.84, the 4-year rate of hospitalization due to heart failure was 0.12, and likelihood of readmission-free survival was 0.80 at 4 years. Left ventricular ejection fraction increased from 30.1 (4.8)% to 57.6 (13.5)% ( P&lt;.001). An unfavorable clinical and functional outcome at 4 years (death, readmission for heart failure or persistence of dilated cardiomyopathy) was recorded in only in 40% of the patients. Multivariate analysis with the Cox model showed appropriate control of blood pressure to be the only independent predictor of a favorable clinical outcome (absence of death or readmission for heart failure) (hazard ratio = 4.58; 95% CI, 1.32-9.83; P=.032). The course of patients with severe dilated cardiomyopathy due to hypertension was favorable in 60% of cases. Adequate control of blood pressure was the only independent predictor of a favorable clinical outcome. Hay poca información sobre la evolución clínica y funcional de los pacientes con insuficiencia cardíaca secundaria a miocardiopatía dilatada de origen hipertensivo. Los objetivos de nuestro trabajo son estudiar la evolución clínica y funcional de estos pacientes, así como identificar los posibles factores predictores de esta evolución. Para ello, hemos evaluado a una serie de 57 pacientes diagnosticados en nuestro centro entre 1994 y 2003 con dicho problema. La edad media de los pacientes fue de 63 ± 11 años, y el 40% eran mujeres. La fracción de eyección ventricular izquierda era del 30,1 ± 4,8%. El tiempo de seguimiento fue de 45 ± 23 meses (mediana, 41 meses). La supervivencia a los 4 años fue 0,84, la tasa de reingresos por insuficiencia cardíaca, 0,12 y la supervivencia libre de reingresos, 0,80. La fracción de eyección aumentó desde el 30,1 ± 4,8% hasta el 57,6 ± 13,5% ( p &lt; 0,001). En conjunto, sólo el 40% de los pacientes presentó mala evolución clínica y/o funcional (muerte, reingreso por insuficiencia cardíaca, persistencia de miocardiopatía dilatada) al final del seguimiento. En el estudio multivariable (modelo de Cox), el adecuado control de la presión arterial fue el único predictor independiente de buena evolución clínica (ausencia de muerte y/o reingreso por insuficiencia cardíaca; razón de riesgo = 4,58; intervalo de confianza del 95%, 1,32-9,83; p = 0,032). La evolución de los pacientes con miocardiopatía dilatada hipertensiva severa es buena en el 60% de los casos. El control de la presión arterial fue el único predictor independiente de buena evolución clínica.</description><identifier>ISSN: 1885-5857</identifier><identifier>ISSN: 0300-8932</identifier><identifier>EISSN: 1885-5857</identifier><identifier>DOI: 10.1016/S1885-5857(06)60648-8</identifier><identifier>PMID: 15373989</identifier><language>eng ; spa</language><publisher>Spain: Elsevier Espana</publisher><subject>Cardiomyopathy, Dilated - complications ; Cardiomyopathy, Dilated - drug therapy ; Cardiomyopathy, Dilated - mortality ; Cardiovascular Agents - therapeutic use ; Dilated cardiomyopathy ; Female ; Heart failure ; Heart Failure - complications ; Heart Failure - drug therapy ; Heart Failure - mortality ; Hipertensión arterial ; Humans ; Hypertension - complications ; Hypertension - drug therapy ; Hypertension - mortality ; Insuficiencia cardíaca ; Male ; Middle Aged ; Miocardiopatía dilatada ; Multivariate Analysis ; Prognosis ; Recovery of Function ; Survival Analysis ; Systemic hypertension ; Systole ; Treatment Outcome ; Ventricular Dysfunction, Left - complications ; Ventricular Dysfunction, Left - drug therapy ; Ventricular Dysfunction, Left - mortality</subject><ispartof>Revista española de cardiologia, 2004-09, Vol.57 (9), p.834-841</ispartof><rights>2004 Sociedad Española de Cardiología</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-cc49281ed57f1b74bd492852e2c42dce1dd7ba73149c9004986a3a1c381810cc3</citedby><cites>FETCH-LOGICAL-c293t-cc49281ed57f1b74bd492852e2c42dce1dd7ba73149c9004986a3a1c381810cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1885585706606488$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15373989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anguita Sánchez, Manuel</creatorcontrib><creatorcontrib>Rodríguez Esteban, Marcos</creatorcontrib><creatorcontrib>Ojeda Pineda, Soledad</creatorcontrib><creatorcontrib>Ruiz Ortiz, Martín</creatorcontrib><creatorcontrib>Romo Peña, Elías</creatorcontrib><creatorcontrib>Mesa Rubio, Dolores</creatorcontrib><creatorcontrib>Vallés Belsué, Federico</creatorcontrib><title>Clinical Outcome and Reversibility of Systolic Dysfunction in Patients With Dilated Cardiomyopathy Due to Hypertension and Chronic Heart Failure</title><title>Revista española de cardiologia</title><addtitle>Rev Esp Cardiol</addtitle><description>There is little information on the clinical and functional course of patients with heart failure secondary to dilated cardiomyopathy due to hypertension. The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis. We evaluated a series of 49 patients with this condition diagnosed in our hospital from 1994 to 2003. Mean age was 63 (11) years, and 40% were women. Left ventricular ejection fraction was 30.1 (4.8)%. Follow-up was 45 (23) months (median, 41 months). Four-year survival was 0.84, the 4-year rate of hospitalization due to heart failure was 0.12, and likelihood of readmission-free survival was 0.80 at 4 years. Left ventricular ejection fraction increased from 30.1 (4.8)% to 57.6 (13.5)% ( P&lt;.001). An unfavorable clinical and functional outcome at 4 years (death, readmission for heart failure or persistence of dilated cardiomyopathy) was recorded in only in 40% of the patients. Multivariate analysis with the Cox model showed appropriate control of blood pressure to be the only independent predictor of a favorable clinical outcome (absence of death or readmission for heart failure) (hazard ratio = 4.58; 95% CI, 1.32-9.83; P=.032). The course of patients with severe dilated cardiomyopathy due to hypertension was favorable in 60% of cases. Adequate control of blood pressure was the only independent predictor of a favorable clinical outcome. Hay poca información sobre la evolución clínica y funcional de los pacientes con insuficiencia cardíaca secundaria a miocardiopatía dilatada de origen hipertensivo. Los objetivos de nuestro trabajo son estudiar la evolución clínica y funcional de estos pacientes, así como identificar los posibles factores predictores de esta evolución. Para ello, hemos evaluado a una serie de 57 pacientes diagnosticados en nuestro centro entre 1994 y 2003 con dicho problema. La edad media de los pacientes fue de 63 ± 11 años, y el 40% eran mujeres. La fracción de eyección ventricular izquierda era del 30,1 ± 4,8%. El tiempo de seguimiento fue de 45 ± 23 meses (mediana, 41 meses). La supervivencia a los 4 años fue 0,84, la tasa de reingresos por insuficiencia cardíaca, 0,12 y la supervivencia libre de reingresos, 0,80. La fracción de eyección aumentó desde el 30,1 ± 4,8% hasta el 57,6 ± 13,5% ( p &lt; 0,001). En conjunto, sólo el 40% de los pacientes presentó mala evolución clínica y/o funcional (muerte, reingreso por insuficiencia cardíaca, persistencia de miocardiopatía dilatada) al final del seguimiento. En el estudio multivariable (modelo de Cox), el adecuado control de la presión arterial fue el único predictor independiente de buena evolución clínica (ausencia de muerte y/o reingreso por insuficiencia cardíaca; razón de riesgo = 4,58; intervalo de confianza del 95%, 1,32-9,83; p = 0,032). La evolución de los pacientes con miocardiopatía dilatada hipertensiva severa es buena en el 60% de los casos. El control de la presión arterial fue el único predictor independiente de buena evolución clínica.</description><subject>Cardiomyopathy, Dilated - complications</subject><subject>Cardiomyopathy, Dilated - drug therapy</subject><subject>Cardiomyopathy, Dilated - mortality</subject><subject>Cardiovascular Agents - therapeutic use</subject><subject>Dilated cardiomyopathy</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Hipertensión arterial</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - mortality</subject><subject>Insuficiencia cardíaca</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Miocardiopatía dilatada</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><subject>Recovery of Function</subject><subject>Survival Analysis</subject><subject>Systemic hypertension</subject><subject>Systole</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - complications</subject><subject>Ventricular Dysfunction, Left - drug therapy</subject><subject>Ventricular Dysfunction, Left - mortality</subject><issn>1885-5857</issn><issn>0300-8932</issn><issn>1885-5857</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUctu1DAUtRCIPuATQF4hugjYceLYK4QybQepUhEFsbQc-0Zj5MSD7VTKX_DJTTojYNfVfeice3TPQegNJR8oofzjHRWiLmpRN-8Jv-CEV6IQz9Dp3_Xz__oTdJbSL0JqJprqJTqhNWuYFPIU_Wm9G53RHt9O2YQBsB4t_gb3EJPrnHd5xqHHd3PKwTuDN3Pqp9FkF0bsRvxVZwdjTvinyzu8cV5nsLjV0bowzGGv827GmwlwDng77yFmGNPKXVXaXQyLNt6CjhlfaeenCK_Qi177BK-P9Rz9uLr83m6Lm9vrL-3nm8KUkuXCmEqWgoKtm552TdXZda5LKE1VWgPU2qbTDaOVNJKQSgqumaaGCSooMYado3eHu_sYfk-QshpcMuC9HiFMSXEuJOOSLsD6ADQxpBShV_voBh1nRYlao1CPUajVZ0W4eoxCiYX39igwdQPYf6yj9wvg0wEAy5v3DqJKZjHTgHURTFY2uCckHgBRGJup</recordid><startdate>20040901</startdate><enddate>20040901</enddate><creator>Anguita Sánchez, Manuel</creator><creator>Rodríguez Esteban, Marcos</creator><creator>Ojeda Pineda, Soledad</creator><creator>Ruiz Ortiz, Martín</creator><creator>Romo Peña, Elías</creator><creator>Mesa Rubio, Dolores</creator><creator>Vallés Belsué, Federico</creator><general>Elsevier Espana</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040901</creationdate><title>Clinical Outcome and Reversibility of Systolic Dysfunction in Patients With Dilated Cardiomyopathy Due to Hypertension and Chronic Heart Failure</title><author>Anguita Sánchez, Manuel ; Rodríguez Esteban, Marcos ; Ojeda Pineda, Soledad ; Ruiz Ortiz, Martín ; Romo Peña, Elías ; Mesa Rubio, Dolores ; Vallés Belsué, Federico</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-cc49281ed57f1b74bd492852e2c42dce1dd7ba73149c9004986a3a1c381810cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; spa</language><creationdate>2004</creationdate><topic>Cardiomyopathy, Dilated - complications</topic><topic>Cardiomyopathy, Dilated - drug therapy</topic><topic>Cardiomyopathy, Dilated - mortality</topic><topic>Cardiovascular Agents - therapeutic use</topic><topic>Dilated cardiomyopathy</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Hipertensión arterial</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - mortality</topic><topic>Insuficiencia cardíaca</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Miocardiopatía dilatada</topic><topic>Multivariate Analysis</topic><topic>Prognosis</topic><topic>Recovery of Function</topic><topic>Survival Analysis</topic><topic>Systemic hypertension</topic><topic>Systole</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - complications</topic><topic>Ventricular Dysfunction, Left - drug therapy</topic><topic>Ventricular Dysfunction, Left - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anguita Sánchez, Manuel</creatorcontrib><creatorcontrib>Rodríguez Esteban, Marcos</creatorcontrib><creatorcontrib>Ojeda Pineda, Soledad</creatorcontrib><creatorcontrib>Ruiz Ortiz, Martín</creatorcontrib><creatorcontrib>Romo Peña, Elías</creatorcontrib><creatorcontrib>Mesa Rubio, Dolores</creatorcontrib><creatorcontrib>Vallés Belsué, Federico</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Revista española de cardiologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anguita Sánchez, Manuel</au><au>Rodríguez Esteban, Marcos</au><au>Ojeda Pineda, Soledad</au><au>Ruiz Ortiz, Martín</au><au>Romo Peña, Elías</au><au>Mesa Rubio, Dolores</au><au>Vallés Belsué, Federico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Outcome and Reversibility of Systolic Dysfunction in Patients With Dilated Cardiomyopathy Due to Hypertension and Chronic Heart Failure</atitle><jtitle>Revista española de cardiologia</jtitle><addtitle>Rev Esp Cardiol</addtitle><date>2004-09-01</date><risdate>2004</risdate><volume>57</volume><issue>9</issue><spage>834</spage><epage>841</epage><pages>834-841</pages><issn>1885-5857</issn><issn>0300-8932</issn><eissn>1885-5857</eissn><abstract>There is little information on the clinical and functional course of patients with heart failure secondary to dilated cardiomyopathy due to hypertension. The objectives of our study were to assess the clinical and functional course of these patients, and to identify possible predictors of prognosis. We evaluated a series of 49 patients with this condition diagnosed in our hospital from 1994 to 2003. Mean age was 63 (11) years, and 40% were women. Left ventricular ejection fraction was 30.1 (4.8)%. Follow-up was 45 (23) months (median, 41 months). Four-year survival was 0.84, the 4-year rate of hospitalization due to heart failure was 0.12, and likelihood of readmission-free survival was 0.80 at 4 years. Left ventricular ejection fraction increased from 30.1 (4.8)% to 57.6 (13.5)% ( P&lt;.001). An unfavorable clinical and functional outcome at 4 years (death, readmission for heart failure or persistence of dilated cardiomyopathy) was recorded in only in 40% of the patients. Multivariate analysis with the Cox model showed appropriate control of blood pressure to be the only independent predictor of a favorable clinical outcome (absence of death or readmission for heart failure) (hazard ratio = 4.58; 95% CI, 1.32-9.83; P=.032). The course of patients with severe dilated cardiomyopathy due to hypertension was favorable in 60% of cases. Adequate control of blood pressure was the only independent predictor of a favorable clinical outcome. Hay poca información sobre la evolución clínica y funcional de los pacientes con insuficiencia cardíaca secundaria a miocardiopatía dilatada de origen hipertensivo. Los objetivos de nuestro trabajo son estudiar la evolución clínica y funcional de estos pacientes, así como identificar los posibles factores predictores de esta evolución. Para ello, hemos evaluado a una serie de 57 pacientes diagnosticados en nuestro centro entre 1994 y 2003 con dicho problema. La edad media de los pacientes fue de 63 ± 11 años, y el 40% eran mujeres. La fracción de eyección ventricular izquierda era del 30,1 ± 4,8%. El tiempo de seguimiento fue de 45 ± 23 meses (mediana, 41 meses). La supervivencia a los 4 años fue 0,84, la tasa de reingresos por insuficiencia cardíaca, 0,12 y la supervivencia libre de reingresos, 0,80. La fracción de eyección aumentó desde el 30,1 ± 4,8% hasta el 57,6 ± 13,5% ( p &lt; 0,001). En conjunto, sólo el 40% de los pacientes presentó mala evolución clínica y/o funcional (muerte, reingreso por insuficiencia cardíaca, persistencia de miocardiopatía dilatada) al final del seguimiento. En el estudio multivariable (modelo de Cox), el adecuado control de la presión arterial fue el único predictor independiente de buena evolución clínica (ausencia de muerte y/o reingreso por insuficiencia cardíaca; razón de riesgo = 4,58; intervalo de confianza del 95%, 1,32-9,83; p = 0,032). La evolución de los pacientes con miocardiopatía dilatada hipertensiva severa es buena en el 60% de los casos. El control de la presión arterial fue el único predictor independiente de buena evolución clínica.</abstract><cop>Spain</cop><pub>Elsevier Espana</pub><pmid>15373989</pmid><doi>10.1016/S1885-5857(06)60648-8</doi><tpages>8</tpages></addata></record>
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subjects Cardiomyopathy, Dilated - complications
Cardiomyopathy, Dilated - drug therapy
Cardiomyopathy, Dilated - mortality
Cardiovascular Agents - therapeutic use
Dilated cardiomyopathy
Female
Heart failure
Heart Failure - complications
Heart Failure - drug therapy
Heart Failure - mortality
Hipertensión arterial
Humans
Hypertension - complications
Hypertension - drug therapy
Hypertension - mortality
Insuficiencia cardíaca
Male
Middle Aged
Miocardiopatía dilatada
Multivariate Analysis
Prognosis
Recovery of Function
Survival Analysis
Systemic hypertension
Systole
Treatment Outcome
Ventricular Dysfunction, Left - complications
Ventricular Dysfunction, Left - drug therapy
Ventricular Dysfunction, Left - mortality
title Clinical Outcome and Reversibility of Systolic Dysfunction in Patients With Dilated Cardiomyopathy Due to Hypertension and Chronic Heart Failure
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