Primary myocardial disease, diabetes mellitus, and small vessel disease.
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The purpose of this study was determination of the prognostic value of clinical and tissue (biopsy) findings of 139 patients with cardiomyopathy. The types of cardiomyopathy were congestive (113 patients) and hypertrophic or constrictive (26 patients). The mean follow-up period of all patients was 4.3 years. Follow-up of the survivors was between 13 months and 11.9 years, mean 5.4 years. Of the 47 cardiac deaths (33.8%), the minimum and maximum follow-up was two weeks and 7.5 years, respectively (mean 2.1 years). Patients with congestive heart failure had the highest five year cardiac mortality rate (51.8%). Coexisting cardiac arrhythmia had no influence on prognosis and an arrhythmia only was benign in most patients. Myocardial hypertrophy or fibrosis or both and myocardium with no pathologic diagnosis had prognostic value. Small-vessel disease was infrequent and not associated with specific clinical manifestations.
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