Fifteen-year mortality and prognostic factors in patients with dilated cardiomyopathy:persistent standardized application of drug therapy and strengthened management may bring about encouraging change in an aging society

BACKGROUND There is scarce data on the long-term mortality and associated prognostic factors in patients with dilated car-diomyopathy(DCM).The study aimed to investigate the all-cause mortality up to 15 years(mean 7.9±5.7 years)in such patients,and the independent prognostic factors influencing their long-term mortality.METHODS One hundred and sixty-six consecutive patients with DCM were prospectively enrolled from 2002 to 2003.The mean age of patients was 59.5±10.4 years,and approximately 57%were male.They were followed up by telephone or outpa-tient visit at least every three months until 2019 or all-cause death occurred.Predictors of mortality were identified using mul-tivariate logistic regression analysis.RESULTS During the 15 years of follow-up,five patients were lost to follow-up,and the complete data records of 161 patients were included in the analysis.Patients were treated with angiotensin-converting-enzyme inhibitors(ACEI)or angiotensin-recept-or blocker(ARB),β-blockers,mineralocorticoid receptor antagonist(MRA),diuretics and digitalis from 2002 to 2004,and main-tained at the maximum tolerated doses between 2004 and 2019.Our safety targets to maintain heart rate and blood pressure at 60-80 beats/min and 90-120/60-80 mmHg,respectively.All-cause mortality in the first five years was 55.9%.The independent risk factors for the 5-year mortality were age≥70 years old(OR=5.45,P=0.006),systolic blood pressure(SBP)>120 mmHg(OR=3.63,P=0.004),6-minute walk distance(6MWD)<450 m(OR=3.84,P=0.001).15-year all-cause mortality was 65.8%.The inde-pendent risk factors for 15-year mortality were age≥70 years old(OR=16.07,P=0.009),LVEF≤35%(OR=5.69,P=0.003),and SBP>120 mmHg(OR=9.56,P<0.001).CONCLUSIONS This study was the first to demonstrate the 15-year survival rate of 34%in DCM patients.The DCM patients’first five-year all-cause mortality decreased significantly after continuous standardized treatment and intensive management.The mortality then plateaued in the following 10 years.Age≥70 years,LVEF≤35%,and SBP>120 mmHg were independent predict-ors of 15-year all-cause mortality.

Quality of life and influencing factors between local and itinerant populations during the COVID-19 pandemic

Objective:To determine the difference in quality of life and its influencing factors between local and itinerant populations in Nanjing during COVID-19.Methods:The quality of life questionnaire,which was based on the Brief Scale of WHO Quality of Life and redesigned by the research group,was used to randomly investigate 1150 people in 5 districts of Nanjing.Results:A total of 1112 valid questionnaires were collected(local population,n=558;itinerant population,n=554).The quality of life of the itinerant population was significantly lower than the local population.The itinerant population scores in physiology,psychology,social relationships,and environment were lower than the local population(all P values<0.05).COVID-19 had a greater impact on the itinerant population than on the local population,especially in medical assistance,enjoyment of life,and interpersonal relationships(all P values<0.05).Conclusion:The itinerant population had a lower quality of life than that of the local population during the prevention and control pandemic of COVID-19,thus more social support and help is warranted.