RECOVERY OF LEFT-VENTRICULAR FUNCTION IN ACUTE NONISCHEMIC CONGESTIVECARDIOMYOPATHY

The extent and time course of recovery of left ventricular function we re investigated in 29 patients with no previous symptoms who had acute nonischemic congestive cardiomyopathy and left ventricular ejection f raction of 0.22 +/- 0.07. Improvement in left ventricular ejection fra ction by at least 0.05 was observed in 24 of the 29 patients and was a chieved within 6 months after the initial evaluation. Progressive impr ovement was seen, with a maximum ejection fraction of 0.45 +/- 0.17 be ing achieved within approximately 18 months. The degree of ejection fr action recovery was not related to the initial clinical or hemodynamic variables. However, the extent of fibrosis detected on endomyocardial biopsy correlated inversely with subsequent changes in ejection fract ion (r = -0.65, p = 0.0003). Thus significant recovery is likely after an acute episode of nonischemic cardiomyopathy and may be progressive during the first year. Recovery is related to the extent of myocardia l fibrosis detected on endomyocardial biopsy but cannot be predicted f rom the initial clinical or hemodynamic presentation.