Key result
Recent DCM treatment era linked to ~85% higher rate of left ventricular reverse remodeling.
Why the study?
Left ventricular reverse remodeling (LVRR) is associated with good prognosis in dilated cardiomyopathy, but recent achievement rates, timing, and associated factors were unclear.
Has the achievement rate and time to left ventricular reverse remodeling (LVRR) improved in recent years for patients with dilated cardiomyopathy?
Observational (n=121)
No
Has the achievement rate and time to left ventricular reverse remodeling (LVRR) improved in recent years for patients with dilated cardiomyopathy?
Absolute Event Rate: 89.5% vs 48.4%
The rate of left ventricular reverse remodeling in dilated cardiomyopathy has significantly increased in recent years, strongly associated with higher beta-blocker doses and lower discharge BNP levels.
Recent left ventricular reverse remodeling rate increases in dilated cardiomyopathy may reflect better care; leaves open roles of beta-blocker dosing and BNP levels.
Background: Left ventricular reverse remodeling (LVRR) is associated with a good prognosis in patients with dilated cardiomyopathy (DCM), so in this study we examined the achievement rates of LVRR, the time taken to LVRR and the factors associated with LVRR in recent cases of DCM. Methods and Results: We enrolled 121 patients with DCM. LVRR was defined as a left ventricular ejection fraction ≥40% at follow-up with a ≥10% improvement. LVRR was observed in 82 patients (68%). The median time to LVRR was 208 days. Multivariate analysis revealed that B-type natriuretic peptide (BNP) levels at discharge (per 1-SD increase, odds ratio: 0.483, 95% confidence interval (CI): 0.224-0.963; P=0.0385) and β-blocker dose (per 1-SD increase, odds ratio: 3.379, 95% CI: 1.644-7.702; P=0.0007) were independently associated with LVRR. When the patients were divided into 2 groups according to the first (2007-2017; n=64) and second (2018-2022; n=57) time periods, there was a significantly higher LVRR achievement rate (48.4% vs. 89.5%) and shorter time to LVRR in the second period than in the first. Conclusions: The LVRR achievement rate in DCM has been increasing, and the time to LVRR has been shortened in recent years. Beta-blocker dose and BNP levels at discharge may be strongly associated with LVRR.
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Wanezaki et al. (2025) conducted an observational in Dilated cardiomyopathy (n=121). Recent time period (2018-2022) vs. First time period (2007-2017) was evaluated on Left ventricular reverse remodeling (LVRR) achievement. The achievement rate of left ventricular reverse remodeling in patients with dilated cardiomyopathy significantly increased from 48.4% in 2007-2017 to 89.5% in 2018-2022.
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