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Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy.

Publication ,  Journal Article
Douglas, PS; Morrow, R; Ioli, A; Reichek, N
Published in: J Am Coll Cardiol
February 1989

Because idiopathic dilated cardiomyopathy is characterized by elevated wall stress and a more spherical left ventricle, the relations among shape, afterload and survival were examined. Thirty-six patients with cardiomyopathy were prospectively studied by two-dimensional echocardiography. Data included echocardiographic short- and long-axis cavity dimensions, their ratio and, with cuff systolic blood pressure, meridional and circumferential end-systolic stress and their ratios. Survivors (n = 16) were followed up for 52 months (range 40 to 76); nonsurvivors (n = 20) died an average of 11 months after study. Survivors had a smaller left ventricular end-diastolic short-axis dimension (6.4 versus 7.1 cm, p less than 0.03) but a similar long-axis length (8.6 versus 8.3 cm). However, overall cavity shape or the ratio of short- to long-axis end-diastolic dimensions was more spherical in those with poorer survival (ratio 0.76 versus 0.68, p less than 0.02). Meridional and circumferential end-systolic stresses were similar in the two groups, but stress was more evenly distributed in the long- and short-axis planes in nonsurvivors (meridional/circumferential stress ratio 0.57 versus 0.52 in survivors, p less than 0.05). Improved survival was associated with an end-diastolic short-axis dimension less than 7.63 cm, a short- to long-axis ratio less than 0.76 and a meridional to circumferential stress ratio less than 0.54. Life table analysis revealed a 28% mortality rate in patients with all three of these characteristics compared with 100% in patients with none. Survivors and nonsurvivors did not differ in systolic cavity dimension, wall thickness, relative wall thickness, cavity volume, percent posterior wall thickening or fractional shortening.(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

February 1989

Volume

13

Issue

2

Start / End Page

311 / 315

Location

United States

Related Subject Headings

  • Stress, Mechanical
  • Regression Analysis
  • Prognosis
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Follow-Up Studies
  • Female
 

Citation

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Douglas, P. S., Morrow, R., Ioli, A., & Reichek, N. (1989). Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy. J Am Coll Cardiol, 13(2), 311–315. https://doi.org/10.1016/0735-1097(89)90504-4
Douglas, P. S., R. Morrow, A. Ioli, and N. Reichek. “Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy.J Am Coll Cardiol 13, no. 2 (February 1989): 311–15. https://doi.org/10.1016/0735-1097(89)90504-4.
Douglas PS, Morrow R, Ioli A, Reichek N. Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1989 Feb;13(2):311–5.
Douglas, P. S., et al. “Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy.J Am Coll Cardiol, vol. 13, no. 2, Feb. 1989, pp. 311–15. Pubmed, doi:10.1016/0735-1097(89)90504-4.
Douglas PS, Morrow R, Ioli A, Reichek N. Left ventricular shape, afterload and survival in idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1989 Feb;13(2):311–315.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

February 1989

Volume

13

Issue

2

Start / End Page

311 / 315

Location

United States

Related Subject Headings

  • Stress, Mechanical
  • Regression Analysis
  • Prognosis
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Heart Ventricles
  • Follow-Up Studies
  • Female