[Prognostic value of exercise parameters and simple non-invasive variables of left ventricular function in dilated cardiomyopathy].
Authors assessed the prognostic value of some simple, routinely used non-invasive parameters in dilated cardiomyopathy. Fifty patients, 43 male and 7 female, mean NYHA class 2.3, treated with digitalis, diuretics and vasodilators, were tested. Mean follow up time was 24 months. The evaluated parameters were as follows: maximal exercise capacity, heart rate, systolic blood pressure, as well as rate-pressure product at peak exercise, their increase during the test, fractional shortening measured by M-mode echocardiography, mean pulmonary capillary wedge pressure estimated by apexcardiography and clinical grade of heart failure (NYHA class). Exercise test was multistage, symptom limited, maximal upright bicycle ergometer test. Both one-way and multivariate analysis showed that except of fractional shortening all of the evaluated parameters related significantly to the survival. According to the one-way analysis maximal exercise capacity, rate-pressure product and systolic blood pressure at peak exercise as well as the estimated value of mean pulmonary capillary wedge pressure proved to be the strongest prognosticators. Multivariate analysis showed that the prognostic value of the rate-pressure product at peak exercise and that of the estimated mean pulmonary capillary wedge pressure proved to be additive, their combined consideration resulted in the highest accuracy of prediction.