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Clinical and Demographic Predictors of Outcomes in Recent Onset Dilated Cardiomyopathy: Results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 Study

Journal of the American College of Cardiology, 2011-09, Vol.58 (11), p.1112-1118 [Peer Reviewed Journal]

2015 INIST-CNRS ;Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Sep 6, 2011 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2011.05.033 ;PMID: 21884947 ;CODEN: JACCDI

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Title:
Clinical and Demographic Predictors of Outcomes in Recent Onset Dilated Cardiomyopathy: Results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 Study
Author: MCNAMARA, Dennis M ; STARLING, Randall C ; COOPER, Leslie T ; BOEHMER, John P ; MATHER, Paul J ; JANOSKO, Karen M ; GORCSAN, John ; KIP, Kevin E ; WILLIAM, G
Subjects: Adult ; African Americans ; Age ; Biological and medical sciences ; Biopsy ; Blood pressure ; Cardiology. Vascular system ; Cardiomyopathy ; Cardiomyopathy, Dilated - ethnology ; Cardiovascular disease ; Confidence intervals ; Diastole ; Drug therapy ; Enzymes ; Female ; Heart ; Heart attacks ; Heart failure ; Heart rate ; Hospitalization ; Humans ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Myocarditis. Cardiomyopathies ; Prospective Studies ; Recovery of Function ; Sex Factors ; Survival analysis ; Transplants & implants ; United States - epidemiology ; Variables ; Ventricular Function, Left
Is Part Of: Journal of the American College of Cardiology, 2011-09, Vol.58 (11), p.1112-1118
Description: We sought to determine clinical and demographic predictors of recovery of left ventricular function for subjects with recent onset cardiomyopathy (ROCM). Although ROCM is a frequent reason for consultation and transplantation referral, its prognosis and natural history on contemporary therapy are unknown. In the multicenter IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study, subjects with a left ventricular ejection fraction (LVEF) of ≤0.40, fewer than 6 months of symptom duration, and an evaluation consistent with idiopathic dilated cardiomyopathy or myocarditis were enrolled. LVEF was reassessed at 6 months, and subjects were followed up for 4 years. LVEF and event-free survival were compared by race, sex, and clinical phenotype. The cohort of 373 persons was 38% female and 21% black, with a mean age of 45 ± 14 years. At entry, 91% were receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and 82% were receiving beta-blockers, which increased to 92% and 94% at 6 months. LVEF was 0.24 ± 0.08 at entry and 0.40 ± 0.12 at 6 months (mean increase: 17 ± 13 ejection fraction units). Transplant-free survival at 1, 2, and 4 years was 94%, 92%, and 88%, respectively; survival free of heart failure hospitalization was 88%, 82%, and 78%, respectively. In analyses adjusted for sex, baseline LVEF, and blood pressure, LVEF at 6 months was significantly lower in blacks than in nonblacks (p = 0.02). Left ventricular end-diastolic diameter at presentation was the strongest predictor of LVEF at 6 months (p < 0.0001). Outcomes in ROCM are favorable but differ by race. Left ventricular end-diastolic diameter by transthoracic echo at presentation was most predictive of subsequent myocardial recovery. (Genetic Modulation of Left Ventricular Recovery in Recent Onset Cardiomyopathy; NCT00575211).
Publisher: New York, NY: Elsevier
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2011.05.033
PMID: 21884947
CODEN: JACCDI
Source: Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
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Clinical and Demographic Predictors of Outcomes in Recent Onset Dilated Cardiomyopathy: Results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 Study

2015 INIST-CNRS ;Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Sep 6, 2011 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2011.05.033 ;PMID: 21884947 ;CODEN: JACCDI

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