Published on:5th may 2014
    Journal of Cardiovascular Disease Research, 2014; 5(1):34-43
    Original Article | doi:10.5530/jcdr.2014.1.6

    Clinical and echocardiogram profile of Cardiomyopathy at tertiary care centre

    Authors:

    Virendra C. Patil1, Neeraj Desai2 and Chetan Galande2

    1Associate professor Department of medicine; Krishna Institute of Medical, Sciences University (KIMSU)

    2Resident Department of medicine; Krishna Institute of Medical, Sciences University (KIMSU).

    Abstract:

    Background: Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with significant morbidity and mortality. The improved recognition or of other factor, the incidence and prevalence of heart failure due to cardiomyopathy appears to be increasing. Aims & Objectives: To study the prevalence, clinical profile and outcome of patients with cardiomyopathies and to study the echocardiographic profile. Material & methods: It is retrospective observational study of 65 patients, with age >15 years and admitted in medical ICU and ward of KIMSU, karad. This study was conducted over period of one year. All eligible subjects underwent relevant investigations including echocardiogram, Doppler study, electrocardiogram, chest radiogram and coronary angiogram. Proforma included age gender presenting complaints, past history, history of medications, clinical examination and laboratory investigations. Trans-thoracic 2-dimensional echocardiogram and Doppler study was done according to the standard protocol. Statistical analysis: Results were given as mean ± SD. Means are compared by unpaired Students t-test. Chi-square was used as appropriate. The observations and data were analyzed in the statistical package social sciences (SPSS) trial version 11. The level of significance was set at P<0.05. Results: A total of 65 patients were admitted from Jan 2010 to Dec 2012 who were diagnosed with cardiomyopathy with mean age of 58.76 years (SD±15.98). Out of the total 65 cardiomyopathy patients admitted 27 (41.53%) had Dilated cardiomyopathy (idiopathic), 15 (23.07%) patients were diagnosed with Ischemic cardiomyopathy. Total 42 (64.61%) patients had Dilated cardiomyopathy (i.e. idiopathic and ischemic dilated cardiomyopathy). A total 11 (16.92%) had Hypertrophic cardiomyopathy (HCM), 2 (3.07%) patients had Hypertrophic obstructive cardiomyopathy (HOCM) with LVOT significant gradient, 5 (7.69%) patients had Restrictive cardiomyopathy (RCMP), 4 (6.15%) had Peripartum cardiomyopathy (PPCM) and 1 (1.53%) patient had miscellaneous (alcohol induced) Cardiomyopathy. Out of 27 patients diagnosed with Dilated Cardiomyopathy (DCM), 15 (55.55%) were male patients and 12 (44.45%) were females. Out of 15 patients diagnosed with Ischemic cardiomyopathy, 7(46.66%) were males and 8(53.33%) were females. Out of 11 patients diagnosed with HCM, 9(81.81%) were males and 2(18.18%) were females. Out of 2 patients diagnosed with HOCM 1(50%) was a male patient and 1(50%) was a female patient. There were 4 female patients who were diagnosed with PPCM. A total of 5 patients were diagnosed with RCMP, out of which 1(20%) was a male patient 4(80%) patients were females. There was 1 male patient diagnosed with cardiomyopathy secondary to chronic alcohol consumption. In present study breathlessness 89.23% was most common presenting symptom and palpitations (81.53%) and cough (58.46%) were next to it with ‘p’ <0.001. Overall VPC’s (36%) were the most common ECG abnormality in patients with cardiomyopathy in present study with ‘p’ value <0.01. The LBBB (35.71%) was more frequently seen in patients with dilated cardiomyopathy with ‘p’ <0.02. The atrial flutter/ fibrillation found more commonly in patients with restrictive cardiomyopathy (80%) with ‘p’ value < 0.02. Total 74.07% of DCM, 86.67% of ischemic cardiomyopathy, 50% of PPCM, 81.82% of HCM, 100% of HOCM, RCMP and alcoholic cardiomyopathy patients had diastolic dysfunction. Idiopathic Dilated cardiomyopathy had 22% (±7.7) of lowest left ventricular ejection fraction (LVEF). Out of total 65 patients two patients with dilated cardiomyopathy succumbed with overall mortality 3.08% and case fatality rate for DCM was 4.76%. Total 96.92% patient were discharged after treatment from the hospital. Conclusion: Present study highlights significant burden of Idiopathic dilated cardiomyopathy and next to it was ischemic cardiomyopathy. A total 6 (9.23%) patients had potentially reversible cardiomyopathy like peripartum, alcoholic and myocarditis. The cardiomyopathy is asymptomatic in the early stages hence early diagnosis and management is of vital importance in the form of judicious use of anticoagulant, digoxin, diuretics, ACE inhibitors and betablocker is mandatory to reduce complications, morbidity and mortality associated cardiomyopathies. Trans-thoracic echocardiogram is an important, simple and noninvasive modality of investigation which can be reproducible for the diagnosis and fallow upof most of the cardiomyopathies.

    Key words: Echocardiogram, Dilated cardiomyopathy, Hypertrophic obstructivecardiomyopathy, Peripartum cardiomyopathy, Restrictive cardiomypathy.