PMID- 22040494 OWN - NLM STAT- MEDLINE DCOM- 20120504 LR - 20111101 IS - 2542-5641 (Electronic) IS - 0366-6999 (Linking) VI - 124 IP - 18 DP - 2011 Sep TI - Factors influencing recovery of left ventricular structure in patients with chronic heart failure. PG - 2868-73 AB - BACKGROUND: Angiotensin converting enzyme (ACE) inhibitors and beta-blockers (betaB) have beneficial effects on left ventricular (LV) remodeling, alleviate symptoms and reduce morbidity and mortality in patients with chronic heart failure (CHF). However the correlation between the d osages of ACE inhibitors, betaB, and recovery of LV structure remains controversial. Clinical factors associated with recovery of normal ventricular structure in CHF patients receiving medical therapy are poorly defined. Here we aimed to identify variables associated with recovery of normal or near-normal structure in patients with CHF. METHODS: We recruited 231 consecutive CHF outpatients, left ventricular ejection fraction (LVEF) 55/50 mm (male/female), who were receiving optimal pharmacotherapy between January 2001 and June 2009, and followed them until December 31, 2009. They were divided into three groups according to LVEDD and whether they were still alive at final follow-up: group A, LVEDD 60/55 mm (male/female); and group C, those who died before final follow-up. Apart from group C, univariate analysis was performed followed by Logistic multivariate analysis to determine the predictors of recovery of LV structure. RESULTS: A total of 217 patients completed follow-up, and median follow-up time was 35 months (range 6 - 108). Twenty-five patients died during that period; the all-cause mortality rate was 11.5%. Group A showed clinical characteristics as follows: the shortest duration of disease and shortest QRS width, the lowest N-terminal brain natriuretic peptide (NT-proBNP) at baseline, the highest dose of betaB usage, the highest systolic blood pressure (SBP), diastolic blood pressure (DBP) and the lowest New York Heart Association (NYHA) classification, serum creatinine, uric acid, total bilirubin and NT-proBNP after treatment. Logistic multivariate analysis was performed according to recovery or no recovery of LV structure. Data showed that LVEF at follow-up (P = 0.013), mitral regurgitation at baseline (P = 0.020), LVEDD at baseline (P = 0.031), and betaB dosage (P = 0.041) were independently associated with recovery of LV diameter. CONCLUSION: Our study suggests that four clinical variables may predict recovery of LV structure to normal or near-normal values with optimal drug therapy alone, and may be used to discriminate between patients who should receive optimal pharmacotherapy and those who require more aggressive therapeutic interventions. FAU - Duan, Hong-Yan AU - Duan HY AD - Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. FAU - Wu, Xue-Si AU - Wu XS FAU - Han, Zhi-Hong AU - Han ZH FAU - Guo, Yong-Fang AU - Guo YF FAU - Fang, Shan-Juan AU - Fang SJ FAU - Zhang, Xiao-Xia AU - Zhang XX FAU - Wang, Chun-Mei AU - Wang CM LA - eng PT - Clinical Trial PT - Journal Article PL - China TA - Chin Med J (Engl) JT - Chinese medical journal JID - 7513795 RN - 0 (Adrenergic beta-Antagonists) RN - 0 (Angiotensin-Converting Enzyme Inhibitors) SB - IM MH - Adrenergic beta-Antagonists/therapeutic use MH - Adult MH - Aged MH - Angiotensin-Converting Enzyme Inhibitors/therapeutic use MH - Female MH - Heart Failure/*drug therapy/*physiopathology MH - Heart Ventricles/*drug effects MH - Humans MH - Male MH - Middle Aged MH - Ventricular Function, Left/drug effects MH - Ventricular Remodeling/*drug effects EDAT- 2011/11/02 06:00 MHDA- 2012/05/05 06:00 CRDT- 2011/11/02 06:00 PHST- 2011/11/02 06:00 [entrez] PHST- 2011/11/02 06:00 [pubmed] PHST- 2012/05/05 06:00 [medline] PST - ppublish SO - Chin Med J (Engl). 2011 Sep;124(18):2868-73.