Substantial systolic improvement and reverse cardiac remodeling in elderly-onset idiopathic dilated cardiomyopathy > or = 65 years of age.

Significant systolic improvement and reverse remodeling in dilated cardiomyopathy (DCM) are well known, however they have been rarely described among elderly subjects. The authors retrospectively reviewed 86 patients with a diagnosis of DCM seen at a clinic during April-November 2005. The authors found 18 patients with elderly-onset idiopathic DCM (age of onset > or = 65 years, mean age 71.8 +/- 6.2 years), who had substantial improvement in left ventricular ejection fraction (LVEF) > or = 20 units (%). During a mean follow-up of 8.6 +/- 5.5 years, mean LVEF and left ventricular end-diastolic diameter improved from 30.6 +/- 7.9% to 58.3 +/- 6.5% (p < 0.0001) and 57.5 +/- 7.0 mm to 44.6 +/- 5.5 mm (p < 0.0001), respectively Fifteen of the 18 patients (83%) had a history of hypertension. Systolic blood pressure at the initial referral clinic correlated with improved contractility (p = 0.0275, r = 0.52). The eighteen patients found in our small patient population suggest that substantial systolic improvement and reverse remodeling is seen in elderly patients with idiopathic DCM.