Cleveland Clinic Led-Study Finds Spontaneous Improvement In Heart Function With Standard Medical Therapy
Study Also Shows Excellent Overall Survival
Cleveland Clinic researchers have found that patients with dilated cardiomyopathy recover with reduction in heart size and increased strength when seen over six months using the American Heart Association and American College of Cardiology’s guidelines for the deployment of evidence-based medications.
Randall C. Starling, M.D., MPH, Vice Chairman, Department of Cardiovascular Medicine at Cleveland Clinic and Primary Author of this study, will present “Left Ventricular Diameter Predicts Recovery in Acute Cardiomyopathy: Results of the IMAC 2 Trial,” on Tuesday, Nov. 6 at the American Heart Association’s (AHA) 27th Annual Scientific Session.
In review of the study’s 260 subjects with acute cardiomyopathy and myocarditis, conditions in which the heart becomes inflamed and weakened, researchers found that over 50% of patients recover with left ventricular ejection fraction of greater or equal to 40 percent. In fact, almost 20 percent normalize with an ejection fraction of 50 percent or greater and survival through two years of observation is excellent.
“Twenty years ago, we never expected patients to get better. There were limited medicinal options and most patients presenting with advanced heart failure were put on the transplant list as the only hope for recovery,” Dr. Starling said. “Today, we are finding that many of the standard medicinal options we have to treat patients can lead to a nearly full recovery. Although still in need of further examination, this is a promising finding that can add new hope for heart failure patients.”
All patients enrolled had symptoms for less than or equal to six months and were diagnosed with acute, idiopathic cardiomyopathy or myocarditis. Medical therapy included 80% beta blockers and 92% ACE or ARB treated.
The results of IMAC 2 reveal a marked spontaneous improvement in ejection fraction over six months, greatest in those with non-dilated LVEDD at baseline, and excellent overall survival in ACM patients treated with standard therapies. Further studies are needed to explore whether this recovery is influenced by genetic background or whether genetic background can be used to predict mediator response and ultimately potential recovery.
The Kaufman Center for Heart Failure facilitates Cleveland Clinic’s participation in national and international clinical trials of investigational treatments and more aggressive or innovative uses of standard heart failure therapies. Cardiologists, cardiac surgeons and researchers collaborate on early diagnosis of congestive heart failure and more aggressive use of therapies to prevent myocardial damage
IMAC II Investigators:
Randall C Starling, Leslie T Cooper, G William Dec, John Boehmer, Peter Liu, Daniel Pauly, John Gorscan, Masaki Tanabe, Kevin Kip, Dennis M McNamara, P.I.
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and education. Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Approximately 1,800 full-time salaried physicians and researchers at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties. In 2006, there were 3.1 million outpatient visits to Cleveland Clinic. Patients came for treatment from every state and from more than 80 countries. There were more than 53,000 hospital admissions to Cleveland Clinic in 2006. Cleveland Clinic’s Web site address is www.clevelandclinic.org.
