Transient cardiomyopathy

  I was interested in an earlier response to a question on improvement in ejection fraction and cardiomyopathy.  Last may I was diagnosed with DCM ( ef 20%) and immediately went on an ACE inhibitor, Coreg, digoxin, and Lasix. In June I received an ICD due to arrythmia. In December my EF was 40% and there had been some decrease in the enlargement of the left ventrical.  This seemed to be great news.  Here are my questions: 1) Can this improvement be considered permanent...or is it due to the meds and I will most likely need to keep taking them to maintain progress? 2. Is cardiomyopathy ever totally "cured"?  3.  I've heard that if DCM is reversed in the first six months this may well be permanent...is this from the date of diagnosis or the actual onset of the viral infection whenever that might have been?  Thank you in advance for considering these issues.  Henry

[CCF CARDIO MD APS]

Dear Henry,
1)Your improvement is likely do in part to the medications and in part to your own recovery.  There is no real answer to this question except to say that so long as  your EF is below normal you will not only need to be on medications, you will also benefit from them.
2)Cardiomyopathy has no cure so to speak, however some patients who get it recover their function in full over the course of the first year or so.
3)You are right that those who normalize their EFs in the first 6 months tend to fully recover permanently.
As for the timing of that critical six months, this is not known, but in general is regarded as starting at the time the virus or initiating event begins to affect the heart, i.e. when the cardiomyopathy is present.
It is in a sense believed that the viral infection may very well occur weeks to months before the cardiomyopathy begins; and of course it may be weeks before the cardiomyopathy produces symptoms.  
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.

[jrrit]

A related discussion, Cardiomyopathy cured? was started.