PMID- 19474760
OWN - NLM
STAT- MEDLINE
DCOM- 20090908
LR  - 20161125
IS  - 1558-2027 (Print)
IS  - 1558-2027 (Linking)
VI  - 10
IP  - 9
DP  - 2009 Sep
TI  - Natural history of dilated cardiomyopathy: from asymptomatic left ventricular 
      dysfunction to heart failure--a subgroup analysis from the Trieste Cardiomyopathy 
      Registry.
PG  - 699-705
LID - 10.2459/JCM.0b013e32832bba35 [doi]
AB  - BACKGROUND: Few data are available in the literature regarding the 
      characteristics and prognosis of asymptomatic patients with idiopathic dilated 
      cardiomyopathy (DCM). AIM: To determine the frequency with which patients 
      affected by DCM are diagnosed in the asymptomatic state as well as to evaluate 
      the natural history of such patients and the factors influencing their outcome. 
      Moreover, we sought to compare the outcome of asymptomatic patients with that of 
      patients with signs of overt heart failure at the time of first evaluation. 
      METHODS AND RESULTS: We analyzed the data of 747 patients with DCM enlisted in 
      the Heart Muscle Disease Registry of Trieste from 1978 to 2007. We divided our 
      population into four groups; group 1 comprised 118 asymptomatic [New York Heart 
      Association (NYHA) I] patients without a history of congestive symptoms (16%), 
      group 2 comprised 102 asymptomatic (NYHA I) patients (14%) with a positive 
      anamnesis for heart failure stabilized in medical therapy, group 3 comprised 327 
      patients (44%) with signs of mild heart failure (NYHA II) and group 4 comprised 
      200 patients (26%) in NYHA III-IV. During the follow-up of 112+/-63 months, 46 
      (21%) of 220 asymptomatic patients with DCM died or underwent heart 
      transplantation. By Cox proportional model, left ventricular ejection fraction of 
      30% or less was a unique independent predictor either for death/heart 
      transplantation (hazard ratio 3.15, 95% confidence interval 1.5-6.7, P=0.003) or 
      for sudden death/major ventricular arrhythmias (hazard ratio 3.9, 95% confidence 
      interval 1.7-9.3, P=0.002). Patients from group 1 had a trend for a better 
      outcome with respect to those from group 2 (P=0.06). In comparison with the 
      asymptomatic patients, those with signs of overt heart failure at baseline had a 
      worse prognosis. CONCLUSION: The proportion of asymptomatic patients with DCM at 
      the moment of first evaluation at our center is significant (30%). Among them, 
      those without a previous history of heart failure had a less advanced disease and 
      a trend for a better long-term outcome on optimal medical treatment. Therefore, 
      early diagnosis may offer better long-term quality of life and even better 
      survival. Further studies on larger populations are indicated.
FAU - Aleksova, Aneta
AU  - Aleksova A
AD  - Cardiovascular Department, Ospedali Riuniti and Department of Clinical 
      Morphological and Technological Sciences, University of Trieste, Trieste, Italy.
FAU - Sabbadini, Gastone
AU  - Sabbadini G
FAU - Merlo, Marco
AU  - Merlo M
FAU - Pinamonti, Bruno
AU  - Pinamonti B
FAU - Barbati, Giulia
AU  - Barbati G
FAU - Zecchin, Massimo
AU  - Zecchin M
FAU - Bussani, Rossana
AU  - Bussani R
FAU - Silvestri, Furio
AU  - Silvestri F
FAU - Iorio, Anna M
AU  - Iorio AM
FAU - Stolfo, Davide
AU  - Stolfo D
FAU - Dal Ferro, Matteo
AU  - Dal Ferro M
FAU - Dragos, Andreea M
AU  - Dragos AM
FAU - Meringolo, Gennaro
AU  - Meringolo G
FAU - Pyxaras, Stelios
AU  - Pyxaras S
FAU - Lo Giudice, Francesco
AU  - Lo Giudice F
FAU - Perkan, Andrea
AU  - Perkan A
FAU - di Lenarda, Andrea
AU  - di Lenarda A
FAU - Sinagra, Gianfranco
AU  - Sinagra G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
RN  - 0 (Cardiovascular Agents)
SB  - IM
MH  - Adult
MH  - Cardiomyopathy, Dilated/*complications/diagnostic imaging/mortality/therapy
MH  - Cardiovascular Agents/therapeutic use
MH  - Disease Progression
MH  - Female
MH  - Heart Failure/diagnostic imaging/*etiology/mortality/therapy
MH  - Heart Transplantation
MH  - Humans
MH  - Italy
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*etiology/mortality/therapy
MH  - Young Adult
EDAT- 2009/05/29 09:00
MHDA- 2009/09/09 06:00
CRDT- 2009/05/29 09:00
PHST- 2009/05/29 09:00 [entrez]
PHST- 2009/05/29 09:00 [pubmed]
PHST- 2009/09/09 06:00 [medline]
AID - 10.2459/JCM.0b013e32832bba35 [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2009 Sep;10(9):699-705. doi: 
      10.2459/JCM.0b013e32832bba35.