Improvement of cardiac function persists long term with medical therapy for left ventricular systolic dysfunction

J Cardiovasc Pharmacol Ther. 2007 Sep;12(3):220-6. doi: 10.1177/1074248407303782.

Abstract

In certain patients with left ventricular (LV) systolic dysfunction, improvements in cardiac function are seen after initiation of medical therapy; however, the long-term stability of ventricular function in such patients is not well described. We retrospectively analyzed 171 patients who had a baseline ejection fraction of 45% or less, a follow-up echocardiogram at 2 to 12 months after initiation of medical therapy, and a final echocardiogram. We found that 48.5% of the patients demonstrated initial improvements in LV function after initiation of medical therapy, and the improvements appear to be sustained (88% of patients) at 44 +/- 21 months follow-up. A nonischemic etiology and younger age were the only independent predictors of change of LV ejection fraction of 10 or more at a mean 8.4 +/- 3.4 months after optimal medical therapy. Our study revealed a trend toward improved long-term survival in individuals with an early improvement in LV ejection fraction with medical therapy, especially in those with sustained improvement.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Age Factors
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Echocardiography
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / prevention & control
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Ventricular Dysfunction, Left / drug therapy*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / mortality

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors