P1570 Evaluation of the Echocardiographic Parameters of Patients Enrolled to the CZECH-ICIT Study

Abstract Background Dilated cardiomyopathy (DCM) is a serious disease leading to heart failure (HF) often in young people. One of the most common causes of DCM is myocarditis. Aim of the study To compare the changes of the echocardiographic (ECHO) parameters of patients enrolled to the CZCEH-ICIT study (randomized study comparing the immunosuppression regiment with conventional heart failure therapy in patients with biopsy proven inflammatory cardiomyopathy). The primary outcome was the change of LVEF in 12 months after randomization. Obtained ECHO parameters were analysed at the baseline and in 12 months during the study . Study population We enrolled 20 patients (17 men and 2 women), age from 18 to 65 years , with diagnosis of recent onset dilated cardiomyopathy. EF LV < 40% and NYHA class II or worse who underwent EMB with confirmation of inflammatory cells in myocardium (> 14 LCA+ and/or > 7 CD3+ cells/mm2). All patients had negative PCR of infectious cardiotropic agents and were randomized in to two groups – IT – (prednison and azathioprin given on the top of standard HF therapy) and conventional HF therapy (CHT). Results Mean value of EF at the baseline clustered by groups were for IT group 22.3% with SD = 4.7 and for CHT group 21.7% with SD = 4. There were no statistically significant differences between two groups at the baseline p = 0.757. The mean value clustered for groups in 12 months were significant different, we found mean EF = 33.7% for IT group with SD = 9.5 and mean EF = 41.3 with SD = 13 for CHT group. The p-value based on t-test in 12 months was p = 0.175 due to huge variability. The results obtained on the basis of linear mixed models show that there is a trend that needs to be considered. At the baseline there is slightly lower level of EF in the group CHT (estimate of difference is -0.63, p = 0.879) the trend is changing in the time in 12 month - there is higher level of EF in CHT (estimate of difference is 11.37, p = 0.008). Total p-value difference based on the F test adjusted obtained for group is p = 0.065, for time p < 0.0001 and for time*group p = 0.537. Conclusion In our small study population we haven´t found positive effect of the immunosuppressive therapy on the development of the ECHO parameters.