Relapse in patients with non-ischemic dilated cardiomyopathy and improved ejection fraction managed with medical therapy.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian heart journal Pub Date : 2026-05-02 DOI:10.1016/j.ihj.2026.04.017

Arghadip Bose, Ajay Bahl, Ankur Gupta, Saurabh Mehrotra, Dinkar Bhasin

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引用次数: 0

Abstract

Background: Relapse is an important problem in nonischemic dilated cardiomyopathy (DCM) patients with improved left ventricular ejection fraction (LVEF). This study aimed to determine the long-term outcomes of patients with non-ischemic dilated cardiomyopathy and improved ejection fraction and analyse the risk of relapse in patients being managed with medical therapy.

Methods: This was a single-centre, retrospective, observational study of all adult patients with non-ischemic DCM enrolled in a cohort. Patients with improved LVEF defined as LVEF <40% at baseline who showed improvement of LVEF to a level ≥40% with an absolute increase in LVEF of ≥10% while on medical therapy were included and followed-up till end of study period.

Results: Of the 548 patients in the non-ischemic DCM group, 131 (23.9%) had an improved LVEF. Of these, 72 (55%) patients had sustained improvement, while 59 (45%) relapsed during follow-up. In the relapsed group, 7 (11.9%) patients had discontinued drug therapy. Relapse occurred at a median duration of 57 months (range 8-224 months) after improvement of LVEF. Of the total patients who had improved LVEF, 3.8% relapsed by 1 year, 23.7% by 5 years and 37.4% by 10 years.

Conclusion: In this non-ischemic DCM cohort 23.9% patients improved their LVEF. Of these, 45% relapsed. Risk of relapse persists over long-term with nearly 50% patients relapsing more than 5 years after their improvement in LVEF. Diabetes mellitus and higher left ventricular internal diameter in diastole at improvement were independent predictors of relapse.

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复发的非缺血性扩张型心肌病患者和改善射血分数管理药物治疗。

背景：复发是左心室射血分数（LVEF）改善的非缺血性扩张型心肌病（DCM）患者的一个重要问题。本研究旨在确定非缺血性扩张型心肌病患者射血分数改善的长期预后，并分析接受药物治疗的患者复发的风险。方法：这是一项单中心、回顾性、观察性研究，纳入了所有成年非缺血性DCM患者。LVEF改善患者定义为LVEF结果：非缺血性DCM组548例患者中，131例（23.9%）LVEF改善。其中72例（55%）患者持续改善，59例（45%）患者在随访期间复发。在复发组中，7例（11.9%）患者停止了药物治疗。LVEF改善后复发的中位持续时间为57个月（范围8-224个月）。在LVEF改善的患者中，3.8%的患者1年复发，23.7%的患者5年复发，37.4%的患者10年复发。结论：在非缺血性DCM队列中，23.9%的患者LVEF改善。其中45%复发。复发的风险长期存在，近50%的患者在LVEF改善后超过5年复发。糖尿病和舒张期左心室内径增高是复发的独立预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

52 days

期刊介绍： Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.