Objective To compare the risk factors for coronary heart disease, blood lipids, and echocardiographic features between patients with dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) to help doctors in primary hospitals diagnose and identify the two heart diseases.
Methods Fifty-three patients treated at the Second Affiliated Hospital of Shantou University Medical College from January 2015 to August 2017 were divided into a DCM group (33-79 years old, 34 cases) and an ICM group (41-77 years old, 19 cases). All patients had cardiac enlargement and underwent coronary angiography to confirm coronary artery disease. The risk factors for coronary heart disease, blood lipids, and echocardiographic characteristics were analyzed.
Results In terms of age composition, the proportion of young and middle-aged patients (<40 years old) in the DCM group was significantly higher than that in the ICM group (20.59% vs 0, χ2=4.51, P=0.034). However, the proportion of old patients (≥60 years old) in the DCM group was significantly lower than that in the ICM group (32.35% vs 68.42%, χ2=6.40, P=0.011). Regarding risk factors for coronary heart disease, male patients accounted for 81.13% of all patients. However, there was no statistically significant difference in the proportion of male patients between the DCM group and ICM group (82.35% vs 78.95%, χ2=0.09, P=0.761). The proportion of patients with hypertension and diabetes in the ICM group was significantly higher than that in the DCM group (73.68% vs 38.24%, χ2=6.13, P=0.013; 52.63% vs 20.59%, χ2=5.74, P=0.017), but the rate of patients with smoking had no significant difference between the two groups (58.82% vs 57.89%, χ2=0.00, P=0.948)). With regard to blood lipid levels, there was no significant difference in the levels of triglycerides or high density lipoprotein cholesterol between the two groups [(1.26±0.59) mmol/L vs (1.46±1.02) mmol/L, t=-0.91, P=0.369; (1.02±0.40) mmol/L vs (1.06±0.27) mmol/L, t=-0.39, P=0.699]. The levels of total cholesterol and low density lipoprotein cholesterol in the DCM group were significantly lower than those in the ICM group [(4.37±1.10) mmol/L vs (5.23±1.32) mmol/L, t=-2.54, P=0.014; (2.80±0.82) mmol/L vs (3.43±1.02) mmol/L, t=-2.46, P=0.018)]. In terms of echocardiographic features, the left ventricular system expansion degree of patients in the DCM group was significantly greater than that in the ICM group. The left atrial diameter, left ventricular end-diastolic diameter, and left ventricular end-systolic diameter of patients in the DCM group were all larger than those in the ICM group [(43.29±6.19) mm vs (38.58±4.82) mm, t=2.86, P=0.006; (65.94±7.30) mm vs (58.94±9.16) mm, t=3.05, P=0.004; (54.68±8.43) mm vs (48.16±7.61) mm, t=2.79, P=0.007)]. Compared with the ICM group, patients in the DCM group had higher proportion of right heart system enlargement(44.12% vs 15.79%, χ2=4.36, P=0.037), but the ejection fraction was mostly decreased [(31.65±7.18)% vs (36.89±9.10)%, t=-2.31, P=0.025]).
Conclusion Comprehensive analysis of risk factors for coronary heart disease, blood lipids, and echocardiography features can be used to identify DCM and ICM.