Study Of The Clinical Features Of Dilated Cardiomyopathy With Pulmonary Hypertension

Background Left-sided heart disease carries a poor prognosis. We investigated the association between pulmonary hypertension (PH) and non-ischemic dilated cardiomyopathy (DCM) as well as its prognosis.Methods205DCM patients were enrolled from Jan2008to Jan2013. Basis on the pulmonary arterial pressure (PASP) measured by2D-echocardiography,147patients were allocated into2groups:DCM without PH group (PASP<40mmHg; n=115) and DCM with PH group (PASP>40mmHg; n=32).The demographic and clinical data, cardiac function, echocardiography and serum total bilirubin and creatinine levels of all patients were analyzed.1year was followed for the occurrence of cardiac events of all the patients, such as cardiac death or re-hospitalization because of worse heart failure.Results Both of the gender proportion and BMI in the two groups were similar. The average age in DCM with PH group is younger than that in DCM without PH (44.3±10.4vs.51.4±9.9, p<0.05). Left atrial dimension, LV diastolic dimension, and LV systolic dimension were significantly larger while ejective fraction were significantly lower in the DCM with PH group than DCM without PH(LAD:44.3±7.3mm vs.38.1±7.4mm, p0.001, LVDd:70.5±11.4mm vs.60.8±8.4mm, p<0.05,LVEF:27.0±13.1%vs.38.3±12.7%, p<0.001). eGFR and serum hemoglobin levels were similar between the two groups(eGFR:74±15vs.72±22ml·min·1·1.73m-2, Hb:13.9±1.9mg/dl vs.14.2±1.7mg/dl, p>0.05). However, the incidence of NYHA Ⅲ(40.6%vs.21.7%,p<0.001), pericardial effusion(14/32vs.34/115, p<0.05), the serum BNP level(545pg/ml vs.139pg/ml, p<0.05)2and the serum total bilirubin level (4.2±30.7umol/L vs.18.3±7.2umol/L,p<0.05) were significantly higher in DCM with PH group than those in DCM without PH. Heart rate(86.9±18.3beats/min vs.74.1±13.5beats/min, p<0.05) and cardiac events increased significantly in the DCM with PH group than in the DCM without PH group(p<0.05).Conclusions The presence of PH was independently associated with an increased incidence of cardiac death in patients with DCM.