Abstract 12107: Persistent Long-Term Apparent Healing in a Large Cohort of Patients With Idiopathic Dilated Cardiomyopathy: Prevalence and Characterization
Objective: To characterize the prevalence, clinical/laboratory features and prognostic significance of persistent long-term apparent healing in idiopathic dilated cardiomyopathy (IDCM).
Background: The prevalence and characterization of persistent apparent healing during the long-term follow-up in large optimally treated IDCM populations are not known.
Methods: We analyzed 581 IDCM patients under optimal treatment. All patients have a potential follow-up of at least 8 years (mean follow-up: 180±56 months). Apparent healing was defined as: left ventricular ejection fraction (LVEF) ≥50% and indexed left ventricular end-diastolic diameter (LVEDDI) ≤33 mm/m2 at mid-term follow-up (19±4 months). Apparent healing was defined as persistent when the above-mentioned parameters were maintained at long-term (103±9 months).
Results: At mid-term 86 (15%) IDCM patients were apparently healed and 38 (44%) among them showed a persistent apparent healing. At univariate analysis no baseline and mid-term parameters predicted persistent long-term apparent healing. In persistently apparently healed patients all main clinical/laboratory parameters reached the normalization at mid-term follow-up and thereafter maintained it; conversely, in non-persistently apparently healed patients the parameters progressive worsened after the 5th year of follow-up despite their normalization at mid-term. During the very-long-term follow-up persistently apparently healed patients showed a better heart transplant (HTx)-free survival (p=0.014) and fewer devices implantations with respect to non-persistently apparently healed patients.
Conclusions: In IDCM a persistent long-term apparent healing was evident in a remarkable proportion of patients and was associated with a stable normalization of main clinical/laboratory features and with an excellent very-long-term survival. No early features were able to predict persistent apparent healing.
- © 2013 by American Heart Association, Inc.