Factors predicting mortality in idiopathic dilated cardiomyopathy.

A study of factors predicting mortality was performed in 201 patients with dilated cardiomyopathy (163 men, 38 women, mean age: 48 +/- 11 years) by multivariate analysis (Cox Model) of 51 clinical, electrocardiographic, echocardiographic and haemodynamic parameters, 56 patients died during follow-up (mean follow-up: 57.1 +/- 29.9 months). 5 year survival was 77 +/- 3%. The following parameters were independent predictors of mortality: first symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms at the time of inclusion; end systolic left ventricular volume; end diastolic left ventricular diameter; pulmonary artery systolic pressure; and their combination had the most accurate predictive value for death. A quantitative score (s) was calculated and used to define three subgroups: A:s less than or equal to 4.5; B: 4.5 less than s less than 6; C:s greater than or equal to 6. Five-year survival was 90 +/- 5% in group A; 84 +/- 4% in B and only 53 +/- 7% in C. In conclusion, overall survival was good in this population of all stage dilated cardiomyopathy; factors related to clinical severity, left ventricular dilation, systolic pulmonary artery pressure and duration of symptoms defined a subgroup of patients with poor prognosis.

[Analysis of predictive factors of mortality in dilated cardiomyopathy. A cooperative study by the Cardiomyopathy Working Group]. / Analyse des facteurs prédictifs de mortalité dans les myocardiopathies dilatées. Etude coopérative du groupe de travail sur les myocardiopathies.

UNLABELLED: An analysis of factors predictive of mortality was undertaken in a group of 201 patients with dilated cardiomyopathy (163 men, 38 women; average age 46 +/- 11 years) using a multivariate analysis (Cox's model) of 51 clinical electrocardiographic, echocardiographic and haemodynamic parameters. The average follow-up period was 57.1 +/- 29.9 months. Fifty-six patients died and the probability of 5-year survival was 77 +/- 3 per cent. The best predictive factor of survival was determined by the combination of the following parameters: presenting symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms before inclusion into the study; left ventricular end diastolic volume; left ventricular end diastolic dimension; systolic pulmonary artery pressure. A quantitative score "S" was calculated which enabled identification of 3 subgroups: A (S less than 4.5); B (4.5 less than S less than 6); C (S greater than 6). The probability of 5-year survival was 90 +/- 5 per cent in Group A, 84 +/- 4 per cent in Group B and 53 +/- 7 per cent in Group C. IN CONCLUSION: global survival was relatively long in this patient population with dilated cardiomyopathy at different stages of evolution; the combination of factors related to clinical severity, left ventricular dilatation, systolic pulmonary artery pressure and duration of symptoms allows identification of a subgroup of patients with a poor prognosis.