Abstract 16052: Prognostic Impact and Therapeutic Implication for Functional Recovery in Nonischemic Dilated Cardiomyopathy With Diabetes Mellitus
Introduction: Although diabetes mellitus (DM) has been identified as a poor prognostic risk in heart failure (HF) patients, the association between DM and therapeutic response in patients with nonischemic dilated cardiomyopathy (DCM) has not been clarified.
Methods: We reviewed 270 consecutive patients diagnosed with DCM. Subjects were evaluated by serial echocardiography during 1 year after the establishment of HF pharmacotherapy, then observed for cardiac events (CEs) such as worsened HF, detected major ventricular tachyarrhythmias or cardiac deaths. Left ventricular reverse remodeling (LVRR) was defined as an increase in LVEF to an absolute value of ≥55% during this 1 year.
Results: During the study period, there were 77 (29%) patients with DM, and CEs were observed in 65 (24%) patients. Presence of DM was recognized as an independent risk for higher incidence of CEs by multivariate analysis (hazards ratio, = 1.98; 95% confidence interval [95%CI], 1.15-3.37; p <0.05, Table). Among the baseline echocardiographic parameters, longer left ventricular dimension (odds ratio [OR], = 1.06; 95%CI, 1.00-1.12; p <0.05) and lower mitral annular velocity at the early diastolic phase on tissue Doppler imaging (OR, = 0.83; 95%CI, 0.55-0.96; p <0.05) were independently related to the presence of DM. Conversely, higher hemoglobin A1c (HbA1c) at baseline was an independent predictor for LVRR achievement (OR, = 1.34; 95%CI, 1.02-1.80; p <0.05). Decreased HbA1c during 1 year from a raised absolute value at baseline was observed in patients with DM and LVRR (Figure).
Conclusions: DM was recognized as a poor prognostic risk in DCM patients with severely impaired LV diastolic function. However, appropriate glycemic control might contribute to functional recovery in DCM patients complicated with DM.
Author Disclosures: Y. Ikeda: None. T. Inomata: None. T. Fujita: None. Y. Iida: None. T. Nabeta: None. S. Ishii: None. T. Mizutani: None. T. Naruke: None. T. Koitabashi: None. J. Ako: None.
- © 2014 by American Heart Association, Inc.