Table 1.
Myofilament change (−)Autophagic vacuole (−) | Myofilament change (+)Autophagic vacuole (−) | Myofilament change (+)Autophagic vacuole (+) | ||
---|---|---|---|---|
(n = 86) | (n = 78) | (n = 86) | P Value | |
Clinical characteristics | ||||
Age (years) | 51.5 ± 14.3 | 55.7 ± 14.6 | 57.7 ± 12.3 | 0.011 |
No. men | 62 (72%) | 66 (85%) | 69 (80%) | 0.136 |
Body mass index, mean (kg/m2) | 26.2 ± 6.5 | 25.9 ± 7.3 | 24.0 ± 3.8 | 0.193 |
Systolic blood pressure (mmHg) | 140.0 ± 33.2 | 130.5 ± 25.5 | 132.9 ± 27.7 | 0.237 |
Diastolic blood pressure (mmHg) | 82.9 ± 22.5 | 81.8 ± 18.3 | 78.5 ± 19.0 | 0.377 |
Heart rate (b.p.m.) | 89.4 ± 25.8 | 89.7 ± 28.2 | 96.4 ± 29.9 | 0.163 |
NYHA scale III or IV | 36 (42%) | 37 (47%) | 41 (48%) | 0.692 |
Family history of DCM | 9 (10%) | 19 (24%) | 11 (13%) | 0.034 |
Comorbidities | ||||
Atrial fibrillation | 24 (28%) | 37 (47%) | 32 (37%) | 0.036 |
Hypertension | 39 (45%) | 42 (54%) | 47 (55%) | 0.407 |
Diabetes | 30 (35%) | 26 (33%) | 34 (44%) | 0.687 |
Renal dysfunctiona | 18 (21%) | 20 (26%) | 25 (29%) | 0.468 |
Clinical chemistry | ||||
B-type natriuretic peptide (pg/mL) | 573.3 ± 634.2 | 744.0 ± 660.4 | 873.3 ± 1036.4 | 0.025 |
C-reactive protein (mg/dL) | 1.9 ± 4.1 | 1.6 ± 5.0 | 1.4 ± 2.5 | 0.937 |
Fasting blood-sugar (mg/dL) | 108.6 ± 31.2 | 103.5 ± 28.6 | 114.6 ± 45.4 | 0.199 |
Hemoglobin A1c (%) | 5.7 ± 0.9 | 5.8 ± 1.0 | 6.1 ± 1.4 | 0.074 |
Creatinine (mg/dL) | 1.1 ± 1.2 | 1.2 ± 1.4 | 1.2 ± 1.6 | 0.307 |
Hemoglobin (g/dL) | 14.2 ± 2.1 | 13.9 ± 2.1 | 13.6 ± 2.1 | 0.170 |
Total bilirubin (mg/dL) | 1.0 ± 0.6 | 0.9 ± 0.5 | 0.9 ± 0.6 | 0.960 |
Echocardiographic data | ||||
Left atrial dimension (mm) | 44.1 ± 7.4 | 45.8 ± 7.3 | 43.5 ± 7.4 | 0.067 |
Left ventricular ejection fraction (%) | 33.3 ± 14.1 | 29.6 ± 11.4 | 31.8 ± 13.2 | 0.245 |
Left ventricular diastolic dimension (mm) | 60.8 ± 8.2 | 63.0 ± 11.4 | 60.7 ± 9.2 | 0.173 |
Left ventricular systolic dimension (mm) | 50.9 ± 9.9 | 54.2 ± 9.0 | 51.5 ± 10.7 | 0.085 |
Interventricular septum thickness (mm) | 10.2 ± 2.5 | 9.7 ± 2.1 | 9.7 ± 1.8 | 0.506 |
Posterior wall thickness (mm) | 10.0 ± 2.1 | 9.6 ± 2.1 | 9.6 ± 1.6 | 0.313 |
Catheterization data | ||||
Left ventricular end diastolic pressure (mmHg) | 13.4 ± 8.3 | 14.6 ± 8.7 | 13.1 ± 7.2 | 0.517 |
Mean pulmonary arterial pressure (mmHg) | 20.5 ± 8.1 | 21.7 ± 9.2 | 20.4 ± 9.1 | 0.513 |
Right atrial pressure (mmHg) | 7.4 ± 3.8 | 8.4 ± 5.0 | 7.8 ± 5.9 | 0.445 |
Pulmonary capillary wedge pressure (mmHg) | 14.0 ± 8.0 | 14.8 ± 8.8 | 13.1 ± 8.4 | 0.495 |
Cardiac index (L/min/m2) | 2.9 ± 0.9 | 2.7 ± 0.7 | 2.7 ± 0.8 | 0.361 |
Medication at admission | ||||
ACE-Is or ARBs | 14 (16%) | 7 (9%) | 6 (7%) | 0.120 |
Treatment in acute phase of heart failure | ||||
Intra-aortic balloon pumping | 1 (1%) | 3 (4%) | 2 (2%) | 0.534 |
Respirator support | 10 (12%) | 9 (12%) | 13 (15%) | 0.731 |
Catecholamine infusion | 9 (10%) | 9 (15%) | 12 (14%) | 0.772 |
Medication in follow up period | ||||
ACE-Is or ARBs | 73 (85%) | 68 (87%) | 76 (88%) | 0.791 |
Beta-blockers | 60 (70%) | 57 (73%) | 66 (77%) | 0.588 |
Diuretics | 61 (71%) | 58 (74%) | 68 (79%) | 0.467 |
Aldosterone receptor antagonists | 42 (49%) | 46 (58%) | 52 (60%) | 0.251 |
Outcome of histopathological morphometry | ||||
Cellular diameter (μm) | 16.9 ± 1.7 | 17.7 ± 1.9 | 17.6 ± 1.9 | 0.008 |
Perinuclear halo | 33 (38%) | 43 (55%) | 43 (50%) | 0.087 |
Nuclear diameter (μm) | 7.9 ± 0.8 | 8.0 ± 0.8 | 7.9 ± 0.8 | 0.483 |
Proportion of fibrosis (%) | 11.2 ± 10.6 | 11.7 ± 10.3 | 8.4 ± 6.9 | 0.174 |
Ultrastructural variables | ||||
Mitochondrial abnormality | 21 (24%) | 14 (18%) | 32 (37%) | 0.017 |
Aggregation of smooth endoplasmic reticulum | 22 (26%) | 15 (19%) | 29 (34%) | 0.107 |
Lamellar body | 9 (10%) | 14 (18%) | 21 (24%) | 0.056 |
Data presented as mean ± SD or as the number of patients, with percentages in parentheses, as appropriate.
Continuous variables were evaluated by two-way repeated-measures analysis of variance in the case of normally distributed data and by the Kruskal-Wallis test if data were not normally distributed. Discontinuous variables were compared using the Chi-squared test.
Renal dysfunction was classified as glomerular filtration rate <60 mL/min/1.73 m2.
NYHA, New York Heart Association; DCM, dilated cardiomyopathy; ACE-I, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker.