Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study.
Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study.
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DOI：
10.1016/j.jacc.2011.05.033
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发表时间：
2011-09-06
影响因子：
24
通讯作者：
IMAC Investigators
中科院分区：
文献类型：
--
作者：
McNamara DM;Starling RC;Cooper LT;Boehmer JP;Mather PJ;Janosko KM;Gorcsan J 3rd;Kip KE;Dec GW;IMAC Investigators
我们试图确定近期发病的心肌病（ROCM）受试者左心室功能恢复的临床和人口统计学预测因素。虽然 ROCM 是咨询和移植转诊的常见原因，但其预后和现代治疗的自然史尚不清楚。在心肌炎和急性心肌病多中心干预（IMAC2）研究中，LVEF≤0.40、出现症状少于六个月且评估符合特发性扩张型心肌病或心肌炎的受试者被纳入，在六个月时重新评估 LVEF，并对受试者进行为期 4 年的随访。按种族、性别和临床表型比较 LVEF 和无事件生存期。 373 名参与者中，38% 为女性，21% 为黑人，平均年龄为 45 ± 14 岁。入组时，91% 的患者正在接受 ACEI 或 ARB 治疗，82% 的患者正在接受 β 受体阻滞剂治疗，6 个月时，这一比例分别增至 92% 和 94%。入组时 LVEF 为 0.24±0.08，六个月时为 0.40±0.12（平均增加 17±13 EF 单位）。 1 年、2 年和 4 年的无移植生存率分别为 94%、92% 和 88%；无心力衰竭住院生存率分别为 88%、82% 和 78%。在根据性别、基线 LVEF 和血压进行调整的分析中，黑人 6 个月时的 LVEF 显着低于非黑人 (p=0.02)。就诊时的 LVEDD 是 6 个月时 LVEF 的最强预测因子 (p<0.0001)。新近发病的扩张型心肌病的预后良好，但因种族而异。就诊时经胸超声检查的 LVEDD 最能预测随后的心肌恢复。
We sought to determine clinical and demographic predictors of recovery of left ventricular function for subjects with recent onset cardiomyopathy (ROCM). While ROCM is a frequent reason for consultation and transplant referral, its prognosis and natural history on contemporary therapy are unknown. In the multicenter Intervention in Myocarditis and Acute Cardiomyopathy (IMAC2) study, subjects with a LVEF ≤ 0.40, less than six months of symptoms and an evaluation consistent with idiopathic dilated cardiomyopathy or myocarditis were enrolled, LVEF reassessed at six months, and subjects followed for 4 years. LVEF and event free survival were compared by race, gender, and clinical phenotype. The cohort of 373 was 38% female, 21% black, with a mean age of 45 ± 14 years. At entry, 91% were receiving ACE inhibitors or ARBs and 82% beta blockers, which increased to 92% and 94% at 6 months. LVEF was 0.24 ± 0.08 at entry and 0.40±0.12 at six months (mean increase 17± 13 EF units). Transplant-free survival at 1, 2 and 4 years was 94, 92 and 88%; survival-free of heart failure hospitalization was 88, 82 and 78%. In analyses adjusted for gender, baseline LVEF, and blood pressure, LVEF at six months was significantly lower in blacks than in non-blacks (p=0.02). LVEDD at presentation was the strongest predictor of LVEF at 6 months (p<0.0001). Outcomes in recent onset dilated cardiomyopathy are favorable but differ by race. LVEDD by transthoracic echo at presentation was most predictive of subsequent myocardial recovery.
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影响因子：
37.8
作者：
CODD, MB;SUGRUE, DD;MELTON, LJ
通讯作者：
MELTON, LJ
影响因子：
6
作者：
Simon, Marc A.;Primack, Brian A.;Teuteberg, Jeffrey;Kormos, Robert L.;Bermudez, Christian;Toyoda, Yoshiya;Shah, Hemal;Gorcsan, John, III;McNamara, Dennis M.
通讯作者：
McNamara, Dennis M.
影响因子：
24
作者：
Sheppard, R;Bedi, M;McNamara, DM
通讯作者：
McNamara, DM
DOI：
10.1056/nejmra0800028
发表时间：
2009-04-09
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cooper LT Jr
通讯作者：
Cooper LT Jr
影响因子：
158.5
作者：
PARRILLO, JE;CUNNION, RE;FAUCI, AS
通讯作者：
FAUCI, AS