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European Heart Journal 2004 25(21):1967; doi:10.1016/j.ehj.2004.05.031
Copyright © 2004 by the European Society of Cardiology.
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Letter to the Editor

Prognosis of heart failure in idiopathic dilated cardiomyopathy: has it improved in tertiary referral centres over the last 10 years?

Laurent Fauchier*, Pierre Cosnay, Dominique Babuty and Jean Paul Fauchier

Service de Cardiologie B et Laboratoire d'Électrophysiologie cardiaque, Centre Hospitalier Universitaire Trousseau, Route de Loches, 37044 Tours, France

Received March 25, 2004; accepted May 26, 2004 * Corresponding author. Tel.: +33 2 47 47 46 50; fax: +33 2 47 47 59 19 (E-mail: lfau{at}med.univ-tours.fr).

We read with great interest the recent article of Schaufelberger et al.1 about improvement of the prognosis of heart failure between 1988 and 2000 in Sweden. Current medical and non-medical therapies (such as the use of ACE-inhibitors and beta-blockers, more frequent use of implantable cardioverter defibrillators, and bi-ventricular pacing have improved the overall prognosis in heart failure whatever the aetiology.

Treatment of myocardial infarction has had major changes during this period. In contrast, it is unclear whether prognosis was really improved in the particular setting of patients with idiopathic dilated cardiomyopathy (IDC) seen in the tertiary referral centers. Despite the improvement of the medical strategy in heart failure and its recognised efficacy, the prognosis of patients with well characterised IDC seemed unchanged in centres similar to our institution in the recent years. The recruitment of more severe patients (larger left ventricular diameters, lower left ventricular ejection fraction and/or higher filling pressures) that might be candidate to some non-medical therapies may thus induce a selection bias in these centres.

References

  1. Schaufelberger M, Swedberg K, Koster M, et al. Decreasing one-year mortality and hospitalization rates for heart failure in Sweden; Data from the Swedish Hospital Discharge Registry 1988 to 2000 Eur Heart J 2004;25:300-307.[Abstract/Free Full Text]

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This Article
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