Characteristics of syncope in patients with dilated cardiomyopathy
Key result
Syncope affects ~3% of DCM patients and shows no difference in LVEF or NYHA class.
- P=1.0
- n=60
Why the study?
What are the prevalence, mechanisms, and risk factors for syncope in patients with dilated cardiomyopathy?
Population
897 patients with a diagnosis of dilated cardiomyopathy, from which 30 patients with syncope were identified…
Design
Case-control
Authors
Discussion
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Implication
Syncope in DCM warrants arrhythmic evaluation despite low prevalence; this case-control study leaves open prospective validation of mechanisms.
Key Points
- This research aims to assess the prevalence of syncope and identify its underlying mechanisms and risk factors in patients with dilated cardiomyopathy (DCM).
- Reviewed 1,610 medical files of 897 patients diagnosed with DCM.
- Identified patients with syncope and compared their profiles to age- and sex-matched patients without syncope in a 1:1 ratio.
- Analyzed clinical and paraclinical factors contributing to syncope in DCM patients.
- 30 patients experienced syncope, equating to a prevalence of 3.3%.
- Cardiac causes were found in 56% of cases, with ventricular arrhythmias in 33% and conduction disorders in 23%.
- Noncardiac causes were more prevalent among syncope patients with hypertension (61.53% vs 23.52%) and diabetes (46.15% vs 5.88%).
Study Design
Type
Case-Control (n=60)
Multicenter
No
Structured PICO
What are the prevalence, mechanisms, and risk factors for syncope in patients with dilated cardiomyopathy?
P
Population
897 patients with a diagnosis of dilated cardiomyopathy (DCM), from which 30 patients with syncope (average age 62.5 years, 27 males) were identified and compared to 30 age- and sex-matched DCM patients without syncope.
C
Comparator
Age- and sex-matched patients with DCM without syncope
O
Outcome
Prevalence, underlying mechanisms, and risk factors for syncope
Main Result
Absolute Event Rate: 35.3% vs 35.3%
p-value: p=1.0
Syncope is a relatively rare finding (3.3%) in patients with dilated cardiomyopathy, but is predominantly of cardiac origin, highlighting the need for thorough arrhythmic and conduction evaluation.
Limitations
- Retrospective study design
- Small number of patients included in the study
- The presumptive cause of syncope was based on clinician's judgment and not always confirmed by ECG monitoring at the time of the event
Cite This Study
Rami et al. (2015) conducted a case-control in Dilated cardiomyopathy (n=60). Syncope vs. No syncope was evaluated on Left ventricular ejection fraction (LVEF) (p=1.0). In patients with dilated cardiomyopathy, syncope had a low prevalence of 3.3% and was primarily of cardiac origin, with no significant differences in ejection fraction or NYHA class compared to patients without syncope.