Electrocardiographic changes in patients with dilated cardiomyopathy
Introduction: Cardiomyopathy is the disease of the heart muscle, which causes deterioration of myocardial functioning. A study was conducted to find electrocardiographic findings in dilated cardiomyopathy.
Materials and methods: This was a hospital-based study, conducted in the department of General Medicine, GSL Medical College. Informed written consent was taken from each patient or his/her attendant prior to including in the study. Patients with dilated cardiomyopathy, both gender, all ages. Heart failure based on Framingham criteria, ECHO criteria – LV ejection fraction less than 45%, with left ventricular or biventricular dilatation, with global hypo-contractility were included in the study. ECG and 2 D Echo have been performed on the patients. Framingham criteria were used for the diagnosis of heart failure. Descriptive statistics were presented in the form of mean ± standard deviation and percentages.
Results: Total 102 patients were included in the study, with a mean age of 56.3 ±12.5 years, the male-female ratio was 1.9. Tachycardia was 61%, left axis deviation was present 34.3% and right axis deviation in 8.8%. Left ventricular end-diastolic and systolic diameters were elevated in most of the patients.
Conclusion: With these findings, it can be concluded severe LV systolic dysfunction is very common among dilated cardiomyopathy patients.
Clyde W Y, Mariell J, Biykem B, Javed B, Donald E C. ACCF/AHA Heart Failure Guideline. J Am Coll Cardiol 2013; 62(16):e147-239. doi: https://doi.org/10.1016/j.jacc.2013.05.019. Epub 2013 Jun 5.
Jefferies JL, Towbin JA. Dilated Cardiomyopathy. The Lancet. 2010;375(9716):752-762. doi: https://doi.org/10.1016/S0140-6736(09)62023-7.
Cohn JN, Bristow MR, Chien KR, Colucci WS, Frazier OH, Leinwand LA. Report of the National Heart, Lung, and Blood Institute Special Emphasis Panel on Heart Failure Research. Circulation. 1997;95:766-770. doi: https://doi.org/10.1161/01.cir.95.4.766.
Richardson P, McKennaw, Bristow M, et al. Report of the 1995 World Health Organization/ International society and Federation of cardiology. Taskforce on the definition classification of cardiomyopathies. Circulat. 1996;93:841. doi: https://doi.org/10.1161/01.cir.93.5.841.
Alvarez J, Orav E, Wilkinson J. Competing risks for death and cardiac transplantation in children with dilated cardiomyopathy: results from the pediatric cardiomyopathy registry. Circulat. 2011;124(7):814-823. doi: https://doi.org/10.1161/CIRCULATIONAHA.110.973826. Epub 2011 Jul 25.
Gallo P, Agozzino L, Arbustini E. The contribution of pathology sections to theItalian Heart Transplant Project in the first 5 years of its activities (1985-1990). GiornaleItaliano di Cardiol. 1992;22(7):843-853.
Keller DI, Carrier L, Schwartz K. Genetics of familial cardiomyopathies and arrhythmias. Swiss Med Wkly. 2002;132(29-30):401-407.
Manolio TA, Baughman KL, Rodeheffer R. Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a National Heart, Lung and Blood institute Workshop). Am J Cardiol. 1992;69:1458-1466. doi: https://doi.org/10.1016/0002-9149(92)90901-a.
Braunwald E, Zipes DP, Libby. Heart disease: A textbook of cardiovascular medicine. Philadelphia: W.B. Saunders Company.
Taylor M R, Carniel E, MestroniL. Cardiomyopathy, familial dilated. Orphanet J Rare Dis. 2006;1:27. doi: https://doi.org/10.1186/1750-1172-1-27.
Dec GW, Fuster V. Medical progress: Idiopathic dilated cardiomyopathy. N Engl J Med. 1994;331(23):1564-1569. doi: https://doi.org/10.1056/NEJM199412083312307.
Coughlin SS, Comstock GW, Boughman KL. Descriptive epidemiology of idiopathic dilated cardiomyopathy in Washington Country, Maryland 1975-1991. J Clin Epidemiol. 1993;46(9):1003-1009. doi: https://doi.org/10.1016/0895-4356(93)90167-y.
Gulati A, Ismail N, Ismail Tl. The Prevalence of Electrocardiographic Abnormalitiesin a Dilated Cardiomyopathy Cohort Characterized by Cardiovascular Magnetic Resonance. N Engl J Med. 2002;90(15):320-325. doi: https://dx.doi.org/10.1186%2F1532-429X-14-54.
The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol. Oct 1993:22 (4): 6A – 13A. doi: https://doi.org/10.1016/0735-1097(93)90455-a.
Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, et al. Contemporary definitions and classification of the cardiomyopathies. An American Heart Association Scientific Statement from the Council of Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006;113(14):1807-1816. doi: https://doi.org/10.1161/CIRCULATIONAHA.106.174287.
Brandenbourg RO, Chazov E, Cherian G, et al. Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br Heart J 1980; 44: 672. doi: https://doi.org/10.1136/hrt.44.6.672.
Paul R, Nandi S, Sinha PK. Epidemiological study of dilated cardiomyopathy from eastern India with special reference to left atrial size. Int J Med Res Health Sci. 2014;3(3):639-644. doi: https://doi.org/10.5958/2319-5886.2014.00410.X.
Rana H, Rathod C, Chavda P, Patel S, Deshpande S. Clinical profile of dilated cardiomyopathy patients presenting to a tertiary care hospital from central Gujarat. Int J Res Med. 2015;4(2):143-146.
Das S, Biswas A, Kapoor M, Seth S, Bhargava B, Rao VR. Epidemiology of cardiomyopathy - A clinical and genetic study of dilated cardiomyopathy: The EPOCH-D study. J Pract Cardio Vasc Sci. 2015;1(1):30-34. doi: https://doi.org/10.4103/2395-5414.157562.
Cohn JN, Johnson GR, Shabetai R, Loeb H, Tristani F, Rector T, et al. Ejection fraction, peak exercise oxygen consumption, cardiothoracic ratio, ventricular arrhythmias, and plasma norepinephrine as determinants of prognosis in heart failure. Circulation. 1993;87(6):VI5-VI16.
Mann DL, Bristow MR. Mechanisms and models in heart failure: the biomedical model and beyond. Circulation. 2005;111(21):2837-2849. doi: https://doi.org/10.1161/CIRCULATIONAHA.104.500546.
Eichhorn EJ, Bristow MR. Medical therapy can improve the biologic properties of the chronically failing heart: a new era in the treatment of heart failure. Circulat. 1996;94:2285-2296. doi: https://doi.org/10.1161/01.cir.94.9.2285.
Dudharejia PJ, Nandania SM. Clinical profile of patients with dilated cardio myopathy (DCM) –A study of 50 cases. J Res Med Den Sci. 2016;4(3):257-259. doi: https://doi.org/10.5455/jrmds.20164317.
Coughlin SS, Gottdiener JS, Baughman KL, Wasserman A, Marx ES, Tefft MC. Black white differences in mortality in idiopathic dilated cardiomyopathy: the Washington, DC, dilated cardiomyopathy study. J Natl Med Assoc. 1994;86(8):583-591.
Elliott P. Diagnosis and management of dilated cardiomyopathy. Heart 2000;84:106-112. doi: https://dx.doi.org/10.1136%2Fheart.84.1.106.
Sonowal N, Rao VD. Clinical Profile of Patients with Dilated cardiomyopathy in a tertiary care center in north east India. J Evol Med Dent Sci. 2014;3(30):8378-8386. doi: https://doi.org/10.14260/jemds/2014/3056.
Rana HM, Chavda P, Rathod CC, Mavani M. Electrocardiographic and Echocardiographic profile of dilated cardiomyopathy patients attending tertiary care hospital in Vadodara. NTL J of Community Med. 2015;6(4):571-574.
Ganesh N, Rampure DM, Rajashekarappa. Etiological study of dilated cardiomyopathy in a tertiary care hospital. J Pharm Biomed Sci. 2014;4(10):910-913.
Ahmad S, M.U. Rabbani, Shirazi N. Evaluation of a Doppler Echocardiographic Index of Global Ventricular Function In Dilated Cardiomyopathy. JK Pract 2006;13(2):87-90. doi: https://dx.doi.org/10.3389%2Ffped.2018.00079.
Nandi S, Paul R, Sinha PK. Echocardiographic study on Dilated Cardiomyopathy from Eastern India. Int J Biomed Res. 2014;5(11):700-703. doi: https://doi.org/10.7439/ijbr.v5i11.804.