Introduction: Idiopathic dilated cardiomyopathy is a mostly progressive irriversible disease with high global burden. A large number of cardiac and systemic diseases can cause systolic impairment and left ventricular dilatation but in majority of patient around twenty identifiable cause is found. Improvement in medical as well as device related strategy adherence to medical management and proper follow up can improve the morbidity and mortality of population effected by this disease.

Materials: Prospective follow up study of Hundred and twelve  consecutively recruited patient over  three years period Framingham's criteria for heart failure and echocardiographic evidence of low ejection fraction LVEF <45% were included in our study. Clinical and echocardiographic evaluation and done at six month interval for assessment of improvement after medical treatment.

Result: Out of total 112 patients 16 patient had died due to cardiac cause either worsening of heart failure, sudden cardiac death, new onset acute coronary syndrome or ventricular arrhythmia. Overall improvement in LVEF and NYHA class achieved in 68% of patients at two years follow-up. Those who achieved the goal are excluded from the study group. 54% of patient achieved NYHA class-I.

Conclusion

1. A substantial number of patients shows LV reverse remodelling.
2. Short duration of symptoms and LV end diastolic dimension at presentation are important predictor of recovery.

• Isotonic exercise is always encouraged in stable heart failure patients.

1. LV end diastolic dimension and NYHA functional class are important predictor of event free survival and clinical recovery.

Keywords: Idiopathic dilated cardiomyopathy. Heart failure, NYHA class, Medical treatment in heart failure.

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Saikat Sau

B.S.M.C. Bankura