Left ventricular ejection fraction (p<0.00001) and systolic pressure (p<0.01), but not morphometric findings in biopsy specimens, were independent predictors of cardiac death.
Cohort (n=68)
Do quantitative morphologic findings from left ventricular endomyocardial biopsy predict cardiac death in patients with congestive cardiomyopathy?
Left ventricular hemodynamics, specifically ejection fraction and systolic pressure, are stronger predictors of survival than morphologic findings from endomyocardial biopsy in patients with congestive cardiomyopathy.
p-value: p=<0.00001
We analyzed data from 68 consecutive patients with congestive cardiomyopathy to evaluate the prognostic significance of quantitative morphologic findings in left ventricular myocardium as compared with the prognostic significance of left ventricular hemodynamics. Left ventricular endomyocardial biopsy specimens were obtained from all patients during diagnostic heart catheterization. Myocardial fiber diameter, volume fraction of interstitial fibrosis, and intracellular volume fraction of myofibrils were determined by light-microscopic morphometry. All patients had normal coronary arteriograms, but reduced left ventricular ejection fractions. There were 23 deaths during a mean follow-up period of 1124 days. Multivariate regression analysis (Cox model) revealed that left ventricular ejection fraction (p less than .00001) and left ventricular systolic pressure (p less than .01), but not morphometric findings in biopsy specimens, were independent predictors of cardiac death. Thus, morphologic findings in the left ventricular myocardium do not contribute significantly to the prognostic evaluation in patients with congestive cardiomyopathy studied by hemodynamic and angiographic methods.
Schwarz et al. (1984) conducted a cohort in congestive cardiomyopathy (n=68). Quantitative morphologic findings and left ventricular hemodynamics was evaluated on cardiac death (p=<0.00001). Left ventricular ejection fraction (p<0.00001) and systolic pressure (p<0.01), but not morphometric findings in biopsy specimens, were independent predictors of cardiac death.
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