How does ventricular function change in dilated cardiomyopathy survivors after 15 years of follow-up.

Purpose. Aim of our study was to evaluate in a group of patients with dilated cardiomyopathy (DC) the evolution of systolic and diastolic ventricular function (specifically LV ejection fraction [EF] and the S/D pulmonary waves) after 15 years of follow-up. Methods. In this prospective study, in 122 patients with DC, EF and S/D were evaluated for the first time in 1995 and the second time 15 years after in the survivors. After 15 years, the vital status was ascertained by contacting patients or their relatives by phone. Results. At baseline we enrolled 92 males and 30 females with DC, with mean age 58±11 years,. LVEF=28.6±6.5% and LV end diastolic diameter= 65.41±7.1 mm. After 15 years, only 37 survived; of whom 18 accepted to undergo a second echocardiographic study. In the survivors revaluated LVEF, and S/D ratio did not show significant variation with respect to the baseline study (Figure 1 and 2). In Figure 1 you can appreciate that LVEF remained stable or mildly improved. In 2 cases it worsened but in 2 cases, it normalized, probably because of a reversible myocardial injury (probably a myocarditis improperly defined as cardiomyopathy at the time of accrual). In figure 2 you can see that S/D ratio tends to worsen toward a restrictive physiology. Conclusion. In these preliminary data, patients with dilated cardiomyopathy with every etiology had a poor long term prognosis, irrespective to the medical treatment. Patients who survived after 15-years, showed, on average, a rather stable systolic and diastolic function. Of interest, in few cases LV function may striking improve, probably because of reversible pathological process unidentified at the first evaluation.