[Prognostic value of the hemodynamic study at rest and during the exercise test in 103 cases of primary dilated cardiomyopathies].

A population of 103 patients with primary dilated cardiomyopathy was studied and followed up for a mean period of 39.8 months. Several variables measured during maximum or symptom-limited exercise tests were compared with parameters recorded during haemodynamic exploration at rest, with the following results: 1. There was no satisfactory correlation between capacity for exercise and haemodynamic data at rest. 2. Some ergometric parameters were found to be of statistically significant value to determine the vital prognosis. The most important were: maximum systolic arterial pressure (SAPmax) at the end of exercise, increased systolic arterial pressure (delta SAP) and heart rate (delta HR) during exercise, product of maximum systolic arterial pressure and maximum heart rate at the end of exercise (SAPmax x HRmax) and variations of this product during exercise [delta(SAP x HR)]. 3. The algorithm: (maximum systolic arterial pressure x maximum heart rate) x ejection fraction x work performed expressed as Kpm makes it possible to establish a predictive index of life expectancy. These results indicate that the exercise test (maximum or symptom-limited)--a simple, inexpensive and easy to repeat examination with no major risk risk--constitutes a valuable means of determining the prognosis of dilated cardiomyopathy. One of its clinical applications would be prior to heart transplantation, when it is still difficult to choose the moment to inform candidates of this possibility.