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European Heart Journal 1990 11(9):824-831;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Factors predicting mortality in idiopathic dilated cardiomyopathy

M. KOMAJDA*,, J. P. JAIS{dagger}, F. REEVES*, B. GOLDFARB{dagger}, J. B. BOUHOUR{ddagger}, Y. JUILLIERES§, J. LANFRANCHI||, P. PEYCELON, PH. GESLIN**, D. CARRIE{dagger}{dagger} and Y. GROSGOGEAT*

*Department of Cardiology, Pitie Salpetriere Hospital Paris
{dagger}Department of Biostatistics, Necker Hospital Paris
{ddagger}Department of Cardiology Nantes
§Department of Cardiology Nancy
**Department of Cardiology Angers
{dagger}{dagger}Department of Cardiology Toulouse, France
||Department of Cardiology Bobigny
Department of Cardiology Clermont-Ferrand

Received 30 March 1989; revised 8 September 1989; .

Address for reprints: M. Komajda, Department of Cardiology, Pitie Salpetriere Hospital, 47 Boulevard de l'Hôpital, 75013 Paris, France

Abstract

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, electrocardio-graphic, 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 ≤4.5; B: 4.5<s<6; C: s ≥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.

Key Words: Dilated cardiomyopathy • prognosis • predicting factors


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