Profile of nonischemic dilated cardiomyopathy patients with long-term survival ≥10 years on medical therapy alone

BACKGROUND: Most studies have focussed on short and medium-term survival in dilated cardiomyopathy (DCM) patients. We aimed to study the profile and changes in left ventricular ejection fraction (LVEF) of nonischemic DCM patients who survived more than 10 years on medical management alone. METHODS: This was a retrospective analysis of patients in the nonischemic DCM cohort recruited from April 2003 to January 2007 with LVEF ≤40%. All patients who survived at least 10 years from the initial DCM diagnosis and were on medical therapy alone were included in the study. RESULTS: Forty of 127 (31.5%) patients survived over 10 years. Mean follow-up duration was 145.48 ± 16.8 months. Baseline left ventricular (LVEF) was 30.01 ± 7.89%. Of these, 26 (65%) patients showed recovery of LVEF. Eight (30.8%) of these had a relapse following initial recovery. 14 patients (35%) did not show improvement in LVEF. Multivariate analysis showed that only variable associated with sustained recovery of LVEF was shorter QRS duration with a mean QRS duration of 95.2 ± 11.3 ms versus 117.4 ± 22.6 ms in the two groups (P < 0.001). CONCLUSIONS: 31. 5% of patients with nonischemic DCM survived more than 10 years with medical therapy alone. Almost two-thirds of these long-term survivors showed recovery of LVEF. Narrow QRS duration predicted sustained recovery of LVEF.