Journal article
Usefulness of Left Ventricular End-Systolic Dimension by Echocardiography to Predict Reverse Remodeling in Patients With Newly Diagnosed Severe Left Ventricular Systolic Dysfunction
The American journal of cardiology, Vol.110(1), pp.83-87
07/01/2012
DOI: 10.1016/j.amjcard.2012.02.054
PMID: 22551737
Abstract
In many patients with left ventricular (LV) systolic dysfunction, the LV ejection fraction (LVEF) a surrogate for reverse remodeling fails to improve despite optimal medical therapy. The early identification of such patients would allow instituting aggressive treatment, including early therapy with implantable cardioverter defibrillators. We sought to establish the predictors of reverse remodeling in patients with LV systolic dysfunction receiving optimal medical therapy. Patients (n = 568) with newly documented LVEF of <= 0.35, who had >= 1 follow-up echocardiogram after >= 3 months, were evaluated. Reverse remodeling was defined as improvement in LVEF to >0.35. The clinical, laboratory, and echocardiographic data were compared between patients with (n = 263) and without (n = 305) reverse remodeling. The mean follow-up was 27 +/- 16 months. Patients who demonstrated reverse remodeling had a significantly greater mean follow-up LVEF (0.51 +/- 0.09 vs 0.25 +/- 0.08; p<0.001). On multivariate analysis, the baseline LV end-systolic diameter index was the strongest predictor of reverse remodeling (odds ratio 5.79; 95% confidence interval 1.82 to 18.46; p<0.001). Other independent predictors of reverse remodeling were female gender (odds ratio 1.88; 95% confidence interval 1.19 to 2.98; p = 0.007), and nonischemic cardiomyopathy (odds ratio 1.65; 95% confidence interval 1.05 to 2.58; p = 0.03). Baseline LVEF was not an independent predictor of reverse remodeling. In conclusion, among patients with newly diagnosed LV systolic dysfunction, the LV end-systolic diameter index, but not the LVEF, at diagnosis, was a strong predictor of reverse remodeling. Patients with a low likelihood of reverse remodeling might benefit from more aggressive heart failure therapy, including the possible early use of implantable cardioverter defibrillators. (C) 2012 Published by Elsevier Inc. (Am J Cardiol 2012;110:83-87)
Details
- Title: Subtitle
- Usefulness of Left Ventricular End-Systolic Dimension by Echocardiography to Predict Reverse Remodeling in Patients With Newly Diagnosed Severe Left Ventricular Systolic Dysfunction
- Creators
- Pradeep K. Bhat - Case Western Reserve UniversityMahi L. Ashwath - Case Western Reserve UniversityDavid S. Rosenbaum - Case Western Reserve UniversityOttorino Costantini - Case Western Reserve University
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.110(1), pp.83-87
- Publisher
- Elsevier
- DOI
- 10.1016/j.amjcard.2012.02.054
- PMID
- 22551737
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Number of pages
- 5
- Language
- English
- Date published
- 07/01/2012
- Academic Unit
- Radiology; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359925202771
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