RESTRICTIVE FILLING PATTERN - A MAJOR NEGATIVE PROGNOSIS FACTOR IN DILATED CARDIOMYOPATHY
Dilated cardiomyopathy (DCM) represents an important cause of chronic heart failure and, thereby, of morbi-mortality worldwide, not only because of its high-risk for sudden death, but also by its evolutive complications (arrhythmias, thromboembolic accidents). The objectives of the study: selection of patients with DCM in sinus rhythm and with a restrictive pattern at echo-Doppler examination, analysis of relevant epidemiological, clinical and echocardiographic parameters and their correlation with a negative prognosis. Material and methods: Retrospective evaluation of a total of 300 patients admitted to the Cardiology Clinic of “Sf. Spiridon” Hospital between January 2017 and December 2017 with the confirmed diagnosis of DCM. Of these, applying the exclusion criteria, we selected 120 patients for further evaluation. Results: Of the analyzed patients, 85 were men and 35 were women, the proportion of those > 60 years old being 71.66%, while those <60 years representing 28.34% of the total, the mean age being 64.4 years. Male sex was significantly correlated with ischemic (p = 0.000001) and ethanolic (p = 0.05) etiology of DCM, as well as with a more severe symptomatology (NYHA III-IV, p = 0.007) compared to women. The restrictive pattern was echocardiographically detected in 79 patients (65.83% of cases) and showed a statistically significant association with the male sex (p = 0.03), the older age (p = 0.00006), but also with an ejection fraction <25% (p = 0.007) or with the presence of the left bundle branch block (p = 0.05). All patients with unfavorable evolution (7.5%) or who died later (4.15%) showed a restrictive pattern, showing a clear link between its presence and a poor prognosis. Conclusions: The present study reveals the major negative influence of the restrictive pattern on the prognosis and subsequent evolution of DCM patients, as well as its interdependence with other clinical and epidemiological parameters.
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