PMID- 27934810
OWN - NLM
STAT- MEDLINE
DCOM- 20170612
LR  - 20181113
IS  - 0971-5916 (Print)
IS  - 0971-5916 (Linking)
VI  - 144
IP  - 2
DP  - 2016 Aug
TI  - Effect of hypertension at presentation on prognosis in patients with dilated 
      cardiomyopathy presenting with normal renal angiogram.
PG  - 281-287
LID - 10.4103/0971-5916.195045 [doi]
AB  - BACKGROUND & OBJECTIVES: Dilated cardiomyopathy (DCM) is a progressive disease of 
      heart with systolic and diastolic dysfunction carrying a poor long-term 
      prognosis. The prognostic index and predictors of mortality are considered to be 
      useful in guiding the treatment. This study was undertaken to evaluate the 
      effects of hypertension at presentation on prognosis in patients with DCM 
      presenting with normal renal and coronary angiogram. METHODS: An observational, 
      analytical, non-interventional and a combination of retrospective and prospective 
      study was conducted in patients between 15 and 75 yr of age with DCM having on 
      and off symptoms while receiving treatment in a cardiology outpatient department 
      for more than a year. Sixty patients who fulfilled the inclusion criteria were 
      enrolled in the study. Left ventricular systolic and diastolic functions were 
      assessed by echocardiography along with New York Heart Association (NYHA) 
      functional class prospectively and at baseline retrospectively. Patients were 
      grouped into two categories: DCM with hypertension at presentation (HTNAP, 
      Category 1) and DCM without hypertension at presentation (NHTNAP, Category 2). 
      The primary end-points were the number and dose of parenteral drugs at 
      hospitalization, duration of hospital stay and change in the left ventricular 
      (LV) systolic function expressed as LV ejection fraction, and the secondary 
      end-points included overall mortality, change in LV and right ventricular 
      systolic and diastolic functions and change in the NYHA functional class between 
      baseline and three month follow up in patients. RESULTS: Thirty five and 25 
      patients presented with HTNAP and NHTNAP, respectively (total 60). The overall 
      mortality was 10 per cent (6/60). The number of hospitalizations was less in 
      HTNAP category and of days of hospital stay was 6.3 in HTNAP and 9.8 in NHTNAP, 
      the difference being significant (P < 0.001). The HTNAP category required less 
      parenteral diuretics and inotropes compared with the NHTNAP category. The 
      echocardiographic parameters showed better improvements in the HTNAP group as 
      compared to the NHTNAP group. Overall, the patients in the <35 yr of age showed 
      the best prognosis (P < 0.001). INTERPRETATION & CONCLUSIONS: Normal or high 
      blood pressure response at acute presentation of DCM leads to better prognosis 
      which may be due to an intact renovascular and an active sympathetic system and 
      can depict the stage of DCM.
FAU - Balije, Swetha
AU  - Balije S
AD  - GSL Medical College & Hospital, Rajahmundry, India.
FAU - Kumar, Ashutosh
AU  - Kumar A
AD  - Department of Cardiology, Narayana Medical College, Nellore, India.
FAU - Bhawani, Goru
AU  - Bhawani G
AD  - Department of Pharmacolgy, Narayana Medical College, Nellore, India.
FAU - Murthy, Kasturi S N
AU  - Murthy KS
AD  - Department of Pharmacolgy, Narayana Medical College, Nellore, India.
FAU - Kumari, Neera
AU  - Kumari N
AD  - Department of Physiology, Sri Krishna Medical College, Muzzafarpur, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian J Med Res
JT  - The Indian journal of medical research
JID - 0374701
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Diuretics)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Angiography
MH  - Cardiomyopathy, Dilated/complications/diagnostic imaging/drug 
      therapy/*physiopathology
MH  - Cardiotonic Agents/administration & dosage
MH  - Coronary Angiography
MH  - Diuretics/administration & dosage
MH  - Echoencephalography
MH  - Female
MH  - Humans
MH  - Hypertension/complications/diagnostic imaging/drug therapy/*physiopathology
MH  - Kidney/diagnostic imaging/*physiopathology
MH  - Male
MH  - Middle Aged
MH  - *Prognosis
MH  - Ventricular Function, Left/drug effects/physiology
PMC - PMC5206882
COIS- None.
EDAT- 2016/12/10 06:00
MHDA- 2017/06/13 06:00
PMCR- 2016/08/01
CRDT- 2016/12/10 06:00
PHST- 2016/12/10 06:00 [entrez]
PHST- 2016/12/10 06:00 [pubmed]
PHST- 2017/06/13 06:00 [medline]
PHST- 2016/08/01 00:00 [pmc-release]
AID - IndianJMedRes_2016_144_2_281_195045 [pii]
AID - IJMR-144-281 [pii]
AID - 10.4103/0971-5916.195045 [doi]
PST - ppublish
SO  - Indian J Med Res. 2016 Aug;144(2):281-287. doi: 10.4103/0971-5916.195045.