The prognostic significance of electrocardiographic variables was retrospectively investigated in 88 patients with dilated cardiomyopathy and with normal coronary arteriograms. During an average follow-up of 3.7 ± 2.9 years, 43 patients died, 26 of progressive heart failure, 15 patients with sudden death, and one due to cerebral embolism. Excluding one patient, who died of esophageal cancer, the cumulative survival rate was 73% at 2 years and 60% at 5 years. By univariate life table analysis, abnormal Q-waves, a QRS duration ⩾0.12s, a cardiothoracic ratio ⩾60%, systolic blood pressure <110mmHg, and left ventricular end-diastolic pressure ⩾15 mmHg were significantly associated with increased mortality within 5 years. Multivariate analysis using Cox's proportional hazards model determined the major independent risk factors in the following order: (1) for all patients; the presence of abnormal Q-waves, left bundle branch block or intraventricular conduction disturbances, left ventricular end-diastolic pressure, systolic blood pressure and the cardiothoracic ratio; (2) for patients without left bundle branch block or intraventricular conduction disturbances; abnormal Q-waves, left ventricular end-diastolic pressure and systolic blood pressure. The present study thus demonstrated that the electrocardiogram could provide independent prognostic predictors in patients with dilated cardiomyopathy, possibly reflecting the severity of myocardial damage.
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Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO, Frye RL (1981) The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 47:525–531
Franciosa JA, Wilen M, Ziesche S, Cohn JN (1983) Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 51:831–836
Unverferth DV, Magorien RD, Moeschberger ML, Baker PB, Fetters JK, Leier CV (1984) Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 54:147–152
Diaz RA, Obasohan A, Oakley CM (1987) Prediction of outcome in dilated cardiomyopathy. Br Heart J 58:393–399
Olshausen KV, Stienen U, Schwarz F, Kubler W, Meyer J (1988) Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 61:146–151
Koga Y, Ogata M, Kihara K, Tsubaki K, Toshima H (1989) Sudden death in hypertrophic and dilated cardiomyopathy. Jpn Circ J 53:1546–1556
Hamby RI, Raia F (1968) Electrocardiographic aspects of primary myocardial disease in 60 patients. Am Heart J 76:316–328
Oakley CM (1974) Clinical recognition of the cardiomyopathies. Circ Res 34 and 35 (Suppl II):152–167
Hatle L, Orjavik O, Storstein O (1976) Chronic myocardial disease. I. Clinical picture related to long-term prognosis. Acta Med Scand 199:399–405
Convert G, Delaye J, Beaune J, Biron A, Gonin A (1980) Prognosis of primary non-obstructive cardiomyopathies. Arch Mal Coeur 73:227–237
Kuhn H, Becker R, Fischer J, Curtius JM, Losse B, Hort W, Loogen F (1982) Studies on the etiology, the clinical course and the prognosis of patients with dilated cardiomyopathy (DCM). Z Kardiol 71:497–508
Wallis DE, O'Connell JB, Henkin RE, Costanzo-Nordin MR, Scanlon PJ (1984) Segmental wall motion abnormalities in dilated cardiomyopathy: A common finding and good prognostic sign. J Am Coll Cardiol 4:674–679
Tamai J, Nagata S, Nishimura J, Yutani C, Miyatake K, Sakakibara H, Nimura Y (1989) Hemodynamic and prognostic value of thallium-201 myocardial imaging in patients with dilated cardiomyopathy. Int J Cardiol 24:219–224
Roberts WC, Siegel RJ, McManus BM (1987) Idiopathic dilated cardiomyopathy: Analysis of 152 necropsy patients. Am J Cardiol 60:1340–1355
Schwarz F, Mall G, Zebe H, Schmitzer E, Manthey J, Scheurlen H, Kubler W (1984) Determinants of survival in patients with congestive cardiomyopathy: quantitative morphologic findings and left ventricular hemodynamics. Circulation 70:923–928
Cohn JN, Archibald DG, Ziesche S, Franciosa JA, Harston WE, Tristani FE, Dunkman WB, Jacobs W, Francis GS, Flohr KH, Goldman S, Cobb FR, Shah PM, Saunders R, Fletcher RD, Loeb HS, Hughes VC, Baker B (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure. N Engl J Med 314:1547–1552
Gradman A, Deedwania P, Cody R, Massie B, Packer M, Pitt B, Goldstein S, for the Captopril-Digoxin Study Group (1989) Predictors of total mortality and sudden death in mild to moderate heart failure. J Am Coll Cardiol 14:564–570
Franciosa JA (1987) Why patients with heart failure die: hemodynamic and functional determinants of survival. Circulation 75 (Suppl IV):20–27
This study was supported in part by a Research Grant for Intractable Diseases from the Ministry of Health and Welfare of Japan.
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Koga, Y., Wada, T., Toshima, H. et al. Prognostic significance of electrocardiographic findings in patients with dilated cardiomyopathy. Heart Vessels 8, 37–41 (1993). https://doi.org/10.1007/BF01744473
- Dilated cardiomyopathy
- Abnormal Q-wave
- Conduction disturbances