Persistent left ventricular dilatation in tachycardia-induced cardiomyopathy patients after appropriate treatment and normalization of ejection fraction

Gopi Dandamudi, Abbas Y. Rampurwala, Jothiharan Mahenthiran, John Miller, Mithilesh Das

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: Tachycardia-induced cardiomyopathy (TIC) seems to be a form of reversible cardiomyopathy. With recurrence, TIC can be more severe and may increase the risk for sudden cardiac death. Objective: We postulate that negative remodeling persists even though ejection fraction (EF) normalizes after appropriate treatment in these patients. Methods: We analyzed 2-dimensional echocardiographic parameters of 24 patients with TIC (male: 21; age: 64.1 ± 15.2 years; atrial arrhythmias: 92%) that improved significantly with treatment (mean time between pretreatment and posttreatment echocardiography: 14 ± 6 months) and compared them with that of age-, gender-, and ejection fraction-matched control subjects without a history of TIC. Results: The majority of posttreatment echocardiographic parameters showed a significant improvement (P <.05) with treatment in patients with TIC, including left ventricular (LV) ejection fraction (31.2% ± 8.2% to 55.0% ± 5.7%) and LV end systolic volume index (55 ± 21 ml/m2 to 33 ± 13 ml/m2). There was no significant difference in LV end diastolic volume index (78 ± 22 ml/m2 to 72 ± 22 ml/m2, P = .15). However, when compared with age-, gender-, and ejection fraction-matched control subjects, posttreatment echocardiographic parameters in TIC patients showed significant differences (TIC vs control group) in LV end systolic volume index (33 ± 13 ml/m2 vs 22 ± 5 ml/m2), LV end diastolic volume index (72 ± 22 ml/m2 vs 51 ± 12 ml/m2), and cardiac index (2.6 ± 0.8 l/min/m2 vs 1.8 ± 0.6 l/min/m2). Conclusion: Although the majority of echocardiographic parameters, including EF, improved significantly with treatment in TIC patients, LV dimensions and volumes remained significantly elevated when compared with control subjects, indicating persistence of negative LV remodeling, even after appropriate treatment and normalization of EF at a mean follow-up of 14 months.

Original languageEnglish
Pages (from-to)1111-1114
Number of pages4
JournalHeart Rhythm
Volume5
Issue number8
DOIs
StatePublished - Aug 2008

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Cardiomyopathies
Tachycardia
Dilatation
Stroke Volume
Therapeutics
Ventricular Remodeling
Sudden Cardiac Death
Echocardiography
Cardiac Arrhythmias
Recurrence
Control Groups

Keywords

  • LV dilatation
  • Tachycardia induced cardiomyopathy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Persistent left ventricular dilatation in tachycardia-induced cardiomyopathy patients after appropriate treatment and normalization of ejection fraction. / Dandamudi, Gopi; Rampurwala, Abbas Y.; Mahenthiran, Jothiharan; Miller, John; Das, Mithilesh.

In: Heart Rhythm, Vol. 5, No. 8, 08.2008, p. 1111-1114.

Research output: Contribution to journalArticle

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title = "Persistent left ventricular dilatation in tachycardia-induced cardiomyopathy patients after appropriate treatment and normalization of ejection fraction",
abstract = "Background: Tachycardia-induced cardiomyopathy (TIC) seems to be a form of reversible cardiomyopathy. With recurrence, TIC can be more severe and may increase the risk for sudden cardiac death. Objective: We postulate that negative remodeling persists even though ejection fraction (EF) normalizes after appropriate treatment in these patients. Methods: We analyzed 2-dimensional echocardiographic parameters of 24 patients with TIC (male: 21; age: 64.1 ± 15.2 years; atrial arrhythmias: 92{\%}) that improved significantly with treatment (mean time between pretreatment and posttreatment echocardiography: 14 ± 6 months) and compared them with that of age-, gender-, and ejection fraction-matched control subjects without a history of TIC. Results: The majority of posttreatment echocardiographic parameters showed a significant improvement (P <.05) with treatment in patients with TIC, including left ventricular (LV) ejection fraction (31.2{\%} ± 8.2{\%} to 55.0{\%} ± 5.7{\%}) and LV end systolic volume index (55 ± 21 ml/m2 to 33 ± 13 ml/m2). There was no significant difference in LV end diastolic volume index (78 ± 22 ml/m2 to 72 ± 22 ml/m2, P = .15). However, when compared with age-, gender-, and ejection fraction-matched control subjects, posttreatment echocardiographic parameters in TIC patients showed significant differences (TIC vs control group) in LV end systolic volume index (33 ± 13 ml/m2 vs 22 ± 5 ml/m2), LV end diastolic volume index (72 ± 22 ml/m2 vs 51 ± 12 ml/m2), and cardiac index (2.6 ± 0.8 l/min/m2 vs 1.8 ± 0.6 l/min/m2). Conclusion: Although the majority of echocardiographic parameters, including EF, improved significantly with treatment in TIC patients, LV dimensions and volumes remained significantly elevated when compared with control subjects, indicating persistence of negative LV remodeling, even after appropriate treatment and normalization of EF at a mean follow-up of 14 months.",
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AU - Miller, John

AU - Das, Mithilesh

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N2 - Background: Tachycardia-induced cardiomyopathy (TIC) seems to be a form of reversible cardiomyopathy. With recurrence, TIC can be more severe and may increase the risk for sudden cardiac death. Objective: We postulate that negative remodeling persists even though ejection fraction (EF) normalizes after appropriate treatment in these patients. Methods: We analyzed 2-dimensional echocardiographic parameters of 24 patients with TIC (male: 21; age: 64.1 ± 15.2 years; atrial arrhythmias: 92%) that improved significantly with treatment (mean time between pretreatment and posttreatment echocardiography: 14 ± 6 months) and compared them with that of age-, gender-, and ejection fraction-matched control subjects without a history of TIC. Results: The majority of posttreatment echocardiographic parameters showed a significant improvement (P <.05) with treatment in patients with TIC, including left ventricular (LV) ejection fraction (31.2% ± 8.2% to 55.0% ± 5.7%) and LV end systolic volume index (55 ± 21 ml/m2 to 33 ± 13 ml/m2). There was no significant difference in LV end diastolic volume index (78 ± 22 ml/m2 to 72 ± 22 ml/m2, P = .15). However, when compared with age-, gender-, and ejection fraction-matched control subjects, posttreatment echocardiographic parameters in TIC patients showed significant differences (TIC vs control group) in LV end systolic volume index (33 ± 13 ml/m2 vs 22 ± 5 ml/m2), LV end diastolic volume index (72 ± 22 ml/m2 vs 51 ± 12 ml/m2), and cardiac index (2.6 ± 0.8 l/min/m2 vs 1.8 ± 0.6 l/min/m2). Conclusion: Although the majority of echocardiographic parameters, including EF, improved significantly with treatment in TIC patients, LV dimensions and volumes remained significantly elevated when compared with control subjects, indicating persistence of negative LV remodeling, even after appropriate treatment and normalization of EF at a mean follow-up of 14 months.

AB - Background: Tachycardia-induced cardiomyopathy (TIC) seems to be a form of reversible cardiomyopathy. With recurrence, TIC can be more severe and may increase the risk for sudden cardiac death. Objective: We postulate that negative remodeling persists even though ejection fraction (EF) normalizes after appropriate treatment in these patients. Methods: We analyzed 2-dimensional echocardiographic parameters of 24 patients with TIC (male: 21; age: 64.1 ± 15.2 years; atrial arrhythmias: 92%) that improved significantly with treatment (mean time between pretreatment and posttreatment echocardiography: 14 ± 6 months) and compared them with that of age-, gender-, and ejection fraction-matched control subjects without a history of TIC. Results: The majority of posttreatment echocardiographic parameters showed a significant improvement (P <.05) with treatment in patients with TIC, including left ventricular (LV) ejection fraction (31.2% ± 8.2% to 55.0% ± 5.7%) and LV end systolic volume index (55 ± 21 ml/m2 to 33 ± 13 ml/m2). There was no significant difference in LV end diastolic volume index (78 ± 22 ml/m2 to 72 ± 22 ml/m2, P = .15). However, when compared with age-, gender-, and ejection fraction-matched control subjects, posttreatment echocardiographic parameters in TIC patients showed significant differences (TIC vs control group) in LV end systolic volume index (33 ± 13 ml/m2 vs 22 ± 5 ml/m2), LV end diastolic volume index (72 ± 22 ml/m2 vs 51 ± 12 ml/m2), and cardiac index (2.6 ± 0.8 l/min/m2 vs 1.8 ± 0.6 l/min/m2). Conclusion: Although the majority of echocardiographic parameters, including EF, improved significantly with treatment in TIC patients, LV dimensions and volumes remained significantly elevated when compared with control subjects, indicating persistence of negative LV remodeling, even after appropriate treatment and normalization of EF at a mean follow-up of 14 months.

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