Background: Some patients with chronic hear failure manifested as dilated cardiomyopathy(D-CMP) would be restored LV systolic function after termination or controlling of tachycardia. We observed time course of improvement of LV dysfunction and clinical outcome in patients with reversible LV systolic dysfunction after treatment of tachycardia and clinical factors affecting improvement of LV dysfunction. Methods: Serial heart rate and echocardiographic parameters were determined in 23 patients (17 male, Age 61.2±11.9 yrs) initially diagnosed as D-CMP and fully recovered from LV dysfunction after termination or controlling of tachycardia. Result: Mean duration of follow-up was 23.4±14.8 (ranged 3-60) months. Accompanying disease were hypertension in 7(30.4%), hyperthyroidism in 3(13.0%), chronic obstructive pulmonary disease in 3(13.0%), chronic alcoholism and severe burn in each 2(8.6%) cases. Six cases (26.1%) had no accompanying disease and showed only atrial fibrillation (lone atrial fibrillation). Atrial fibrillation with rapid ventricular response was most frequent (19 subjects, 86.1%. Recovery of LV function was achieved within 1 months in 12 (52.2), between 1 month and 6 months in 4 (17.4%) and over 6 months in 7 (30.0%) cases. Subjects improved within 1 month (group A) were older than that of over 1 month (group B) (65.7±6.5 vs 54.0±12.8 yr, p<0.001) and had longer duration of symptom of heart failure (1.4±1.0 vs 3.9±2.1 months, p<0.01). Heart rate at admission, fractional shortening and LVEF were not different between two groups, but LV diastolic (55.3±4.8 vs 63.0±6.0 mm, p<0.01) and systolic (46.8±4.4 vs 55.9±7.5mm, p<0.01) dimensions were significantly smaller in group A. Recurrent tachyarrhythmia occurred in 4 cases who had decreased dosage of amiodarone (below 200mg/day) and stopped medication. Two cases died of intracranial hemorrhage and lung cancer each other. Conclusion: These findings suggested that in patients with T-CMP, the time for recovery of LV dyfunction depend on duration of symptom after the onset of heart failure and degree of structural impairment of LV. Once the LV function was recovered, it is well preserved and showed preferable outcome.
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