Factors Influencing the Mortality of Dilated Cardiomyopathy

We ingestigated the symptoms, clinical and laboratory findings that may influence the prognosis of dilated cardiomyopathy (DC), in 30 male and 15 female patients, hospitalized and followed in the period between June 1988-October 1991 at the Istanbul Institute of Cardiology. Since three patients lacked a follow-up, the prognosis was studied in 42 patients. Age, sex, etiologic factors, dyspnea, tachycardia, chest pain duration, functional capacity before admittance, third heart sound, mitral regurgitation murmur, hepatomegaly, cardiothoracic index, rhythm and conduction disturbances by resting ECG and Holter recording, echocardiographic ejection fraction, fractional shortening, left ventricular and atrial diameter, hemodynamic left ventricular enddiastolic and end-systolic pressures, illness and follow-up duration were studied as potential factors affecting the prognosis of DC. There were 16 deaths (38.1 %) during 11.4-month (mean) follow up. The patients were followed up for a total 40 patient-years. This implies an average annual death rate of 40 %. The leading prognostic factors influencing mortality turned out to be: functional capacity (p: 0.0003), cardiothoracic index (p: 0.004), presence of third sound (p<0.005), ejection fraction (p: 0.03) fractional shortening (p: 0.03) and duration since onset of dyspnea (p:0.048). These factors are, indeed, the morphological, clinical and symptomatologic findings of congestive heart failure.