| ObjectiveTo investigate the clinical data for patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM) at department of cardiology in our hospital from Oct 2006 to June 2008.To analyzed the diagnosis and treatment current situation of DCM.MethodsA retrospective survey was perfromed at department of cardiology in our hospital from Oct 2006 to June 2008. Patients with DCM of the general situation,diagnosis,echocardiography,complications,medication usage was recorded.According to the NYHA classification,the patients were divided into NYHA classⅡ,Ⅲ,Ⅳgroups.According to CHADS2 score DCM patients with AF were divided into CHADS2≥2,CHADS2<2 groups.Results(1)A total of 111 patients with DCM were enrolled.There were 86 cases of male (77.5%)and 25 cases female (22.5%) repectively,therefore the ratio of male to female was 3.4:1.The mean age was 59.6±13.5 year old.(2) The constituent ratio of NYHAⅡ,ⅢandⅣwas 14.4%,50.5%,35.1% respectively.(3)Shortness of breath,dyspnea and palpitation were the common symptom and the occurrence rate was 67.6%,58.6%,53.2% repectively. Cardiac dilatation,cardiac murmur,oedema legs were the common signs and the occurrence rate was 40.5%,37.8%,30.6%.(4)Left ventricular end systolic dimension and left ventricle end diastolic dimension were (57.74±9.71)mm and (68.99±10.12)mm repectively. The mean value of Left ventricular ejectioin fraction(LVEF)and Fractional shortening(FS) were (31.71±7.65)% and (15.89±4.19)% repectively.3 cases of thrombosis were found in left ventricular,but no in Atrial.(5) Arrhythmias was observed in 77 patients(80.2%),in which the atrial arrhythmia was the most(53.1%) type.Moreover,atrial fibrillation(AF)(31.3%) and left bundle branch block(LBBB)(22.9%)was found in the DCM patients.(6)In the complication of DCM,hyperuricemia,pulmonary infection,electrolyte disorder and Hypoproteinemia were the most common and the rate of them were 43.2%, 42.3%,37.8% and 31.5% respectively.(7)Medical treatments included diuretics (87.4%),ACEI (71.2%),ARB (27.9%),ACEI/ARB (89.2%),β2 receptor blockers (51.4%),aldosterone (89.2%),digoxin (72.1%).(8)The utilization rate of drug combination was 96.9% in DCM patients with NYHAⅢandⅣ,diuretics+ ACEI/ARB +β2 receptor blockers + aldosterone+ digoxin was 34 cases (35.1%);diuretics + ACEI/ARB +β2 receptor blockers + aldosterone was 9 cases(9.3%);diuretics + ACEI/ARB + aldosterone was 7 cases(7.2%);ACEI/ARB + aldosterone was 2 cases(2.1%);ACEI/ARB +β2 receptor blockers was 1 cases(1.0%).(9)There were 30 cases (27.0%) of DCM patients with AF.There were 16 cases (53.3%)and 14 cases (46.7%) in CHADS2≥2 group and CHADS2 <2 group respectively.Futhermome,there were 5 cases(31.3%) with cerebral infarction in CHADS2≥2 group.However,only 1 patients(6.25%) was treated with Warfarin in CHADS2≥2group and 5 cases with Aspirin.5 cases(31.3%) was treated with Warfarin in CHADS2<2 group and 3 cases(21.4%) with Aspirin.ConclusionMale was more common than female in patients with DCM in the study.Most patients with DCM manifested heart failure of NYHAⅢandⅣ,with complex arrhythmias,Enlargement of left ventricle with EF reduction was the feature of echocardiography in patients with DCM.Hyperuricemia,pulmonary infection,electrolyte disorder and Hypoproteinemia were the most common complications in DCM.About 1/6 DCM patients with AF complicated cerebral infarction.The Main treatment of DCM was anti-heart failure drugs.For the patients without contraindication,not usage ofβ2 receptor blockers was the most drug for the paitents with DCM,and the other followed by ACEI/ARB,diuretics,aldosterone.The useage of Warfarin in DCM patients AF (high risk for thrombus) is very low.Therefore,the current situation must be changed.
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