PMID- 32150669
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 7
IP  - 2
DP  - 2020 Apr
TI  - Long-term prognostic value of ultrastructural features in dilated cardiomyopathy: 
      comparison with cardiac magnetic resonance.
PG  - 682-691
LID - 10.1002/ehf2.12662 [doi]
AB  - AIMS: This study aims to determine the implications associated with long-term 
      prognosis of heart failure (HF) in patients with dilated cardiomyopathy (DCM) 
      presenting initially as decompensated HF. We stratified the phase of DCM patients 
      without late gadolinium enhancement (LGE) based on ultrastructural changes in 
      cardiomyocytes. METHODS AND RESULTS: Left ventricular (LV) endomyocardial biopsy 
      was performed in 55 consecutive DCM patients with initial decompensated HF. 
      Ultrastructural changes in cardiomyocytes detected by electron microscopy were 
      compared with data including LGE with cardiac magnetic resonance and HF 
      recurrence. Of the 55 DCM patients, 24 (44%) showed LGE, and 26 (47%) showed 
      recurrence decompensated HF, while 23 patients (42%) showed autophagic vacuoles 
      in cardiomyocytes by electron microscopy. Multivariate analysis identified atrial 
      fibrillation [hazard ratio (HR), 3.40; 95% confidence interval (CI), 1.45-7.98], 
      haemoglobin level (HR, 0.82; 95% CI, 0.68-0.99), beta-blocker use (HR, 0.18; 95% 
      CI, 0.05-0.74), and autophagic vacuoles (HR, 0.25; 95% CI, 0.09-0.65) as 
      predictors of HF recurrence in the total patient population. In patients without 
      LGE, only autophagic vacuoles were independent predictors of readmission because 
      of HF (HR, 0.29; 95% CI, 0.09-0.90). In patients with LGE, atrial fibrillation 
      (HR, 19.10; 95% CI, 2.97-123.09), and mid-linear LGE (HR, 12.96; 95% CI, 
      2.02-82.94) were independent predictors of readmission because of HF. 
      CONCLUSIONS: In DCM patients with LGE, characterised by progression of LV 
      remodelling, the LGE pattern was a predictor of HF recurrence, whereas in 
      patients without LGE, absence of autophagic vacuoles was a predictor of HF 
      recurrence.
CI  - (c) 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Saito, Tsunenori
AU  - Saito T
AUID- ORCID: 0000-0002-8214-2736
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
FAU - Asai, Kuniya
AU  - Asai K
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
FAU - Tachi, Masaki
AU  - Tachi M
AD  - Department of Radiology, Nippon Medical School, Tokyo, Japan.
FAU - Sato, Shigeru
AU  - Sato S
AD  - Tokyo Electron Microscopy Laboratory, Chiba, Japan.
FAU - Mozawa, Kosuke
AU  - Mozawa K
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
FAU - Adachi, Akiko
AU  - Adachi A
AD  - Division of Morphological and Biomolecular Research, Graduate School of Medicine, 
      Nippon Medical School, Tokyo, Japan.
FAU - Sasaki, Yoshihiro
AU  - Sasaki Y
AD  - Division of Morphological and Biomolecular Research, Graduate School of Medicine, 
      Nippon Medical School, Tokyo, Japan.
FAU - Amano, Yasuo
AU  - Amano Y
AD  - Department of Radiology, Nihon University Hospital, Tokyo, Japan.
FAU - Mizuno, Kyoichi
AU  - Mizuno K
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
FAU - Kumita, Shin-Ichiro
AU  - Kumita SI
AD  - Department of Radiology, Nippon Medical School, Tokyo, Japan.
FAU - Shimizu, Wataru
AU  - Shimizu W
AD  - Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
LA  - eng
GR  - Support Grant 2018/Nippon Medical School Alumni/International
GR  - 17K16026/Japan Society for the Promotion of Science/International
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200309
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - *Cardiomyopathy, Dilated/diagnosis
MH  - Contrast Media
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Spectroscopy
MH  - Prognosis
PMC - PMC7160479
OTO - NOTNLM
OT  - Autophagy
OT  - Cardiac magnetic resonance
OT  - Dilated cardiomyopathy
OT  - Heart failure
OT  - Late gadolinium enhancement
OT  - Left ventricular reverse remodelling
COIS- None declared.
EDAT- 2020/03/10 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/03/09
CRDT- 2020/03/10 06:00
PHST- 2019/09/04 00:00 [received]
PHST- 2020/01/14 00:00 [revised]
PHST- 2020/02/06 00:00 [accepted]
PHST- 2020/03/10 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/03/10 06:00 [entrez]
PHST- 2020/03/09 00:00 [pmc-release]
AID - EHF212662 [pii]
AID - 10.1002/ehf2.12662 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2020 Apr;7(2):682-691. doi: 10.1002/ehf2.12662. Epub 2020 Mar 9.