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PubMed2002

Validation of the Medical Research Council and a newly developed prognostic index in patients with malignant glioma: how useful are prognostic indices in routine clinical practice?

Although different prognostic indices for malignant gliomas have been developed, their validity outside of clinical trials has not been widely tested. The aim of this study was to determine whether the Medical Research Council (MRC) brain tumour prognostic index was able to stratify patients for survival managed in routine practice, and secondly to compare the results with our newly developed prognostic score which included tumour grade and only 3 prognostic groups. The MRC and the new prognostic index were calculated for a group of 119 adult patients with malignant glioma managed by surgical resection/biopsy and post-operative radiotherapy. For the MRC and new score, 6 and 3 prognostic groups were defined, respectively. For all patients median survival was 11 (2-66) months. The overall survival rate at 12 and 24 months were 43% and 18%, respectively. The MRC median and two-year survival rates were 14 months and 26% for a score of 1-10, 14 months and 27% for a score of 11-15, 13 months and 22% for a score of 16-20, 8 months and 10% for a score of 21-25, 8 months and 0% for those scoring 26-33. There was only one patient in the 34-38 group. For the new prognostic index, median and two-year survival rates were respectively 16 and 26%; 12 and 23%; 8 and 7% for the good, intermediate and poor prognostic groups. Both indices were significant factors for survival in univariate analysis (MRC index, p = 0.0089, new index p = 0.0002), but not in multivariate analysis. Both the MRC and our newly devised prognostic score were able to separate patients into good and poor prognostic groups, which may aid in treatment decisions, although there was less differentiation between the MRC groups especially over the first year. Both scores use routinely available factors. However, inclusion of tumour grade in the new score may be an advantage over the MRC index.

Adult↗
PubMed2000

Long-term follow-up study of IgM associated nephrotic syndrome patients: clinical outcome and prognostic indicators.

RATIONALE: Even though it is the most common primary glomerular disease, the natural history and prognosis of IgM associated nephrotic syndrome have not been well established. OBJECTIVES: To determine the (1) responsiveness to prednisolone therapy, (2) long-term clinical and laboratory outcomes, and (3) prognostic indicators to prednisolone therapy in patients with IgM associated nephrotic syndrome. STUDY DESIGN: Clinical descriptive, longitudinal study. SUBJECTS: Seventy two biopsy-proved IgM associated nephrotic syndrome patients, diagnosed between 1978-1996 at Vajira Hospital, Bangkok, were included in the study. METHOD: Clinical parameters with age, sex, duration of edema, blood pressure and laboratory findings such as hematuria, BUN, creatinine, albumin, and cholesterol, 24-hour urine protein, and stool examination, were collected pre-renal biopsy. Each patient was treated with 45-60 mg of prednisolone according to body weight, for up to 8 weeks. Each patient was followed-up every 4-weeks for clinical and laboratory evaluations, and for adjusting the steroid dosage. Clinical responses were stratified into 3 groups as steroid responsive (SRP), steroid dependent (SD), and steroid resistant (SRS). MAIN OUTCOME MEASURES: (1) Frequency and types of steroid responsiveness. (2) Incidence of hypertension, hematuria, renal insufficiency, end-stage renal disease, and survival during the follow-up. (3) Prognostic indicators for initial clinical response to prednisolone, and for long-term morbidity and mortality. RESULTS: Forty eight of the 72 patients (66.67%) were responsive to prednisolone at 8-weeks, the 24 remaining patients (33.33%) were nonresponsive. High proteinuria of 7.66 +/- 4.14 g/D was the only good prognostic indicator to initial prednisolone therapy (p < 0.03). During the follow-up, 42(58.33%), 26(36.11%), and 4(5.56%) patients were SRP, SD, and SRS, respectively. There were no prognostic indicators associated with long-term steroid responsiveness. Of the 60 patients followed-up for more than one year; 34, 15 and 11 patients were followed-up for 1-5, > 5-10 and > 10 years, respectively. Hematuria and proteinuria were more frequent among the SRS group (p < 0.01 and 0.02, respectively) during the follow-up. Only one patient, initially in the SD group, and later on became SRS, died. CONCLUSION: Patients with IgM associated nephrotic syndrome had very good response to prednisolone therapy. It had a very slow progressive course, with low morbidity and mortality.

Adolescent↗
PubMed1997

p53 serum antibodies as prognostic indicator in head and neck cancer.

p53 antibodies are a new serological parameter of unknown potential in patients with malignancies. Their occurrence has been described in various types of cancer patients. The mechanism underlying the immunization process is still unclear. We investigated the incidence of p53 serum antibodies in 143 head and neck cancer patients with an enzyme-linked immunosorbent assay. The posttherapy course of two matched study groups (n = 38 each), one p53-antibody-seropositive and one p53-antibody-seronegative, was followed up for 24 months. Thirty-nine head and neck cancer patients (27.3%) were seropositive for p53 antibodies. During the follow-up, the p53-antibody-seropositive patients accounted for more local tumor recurrences (n = 12 versus n = 8) and more tumor-related deaths (n = 11 versus n = 5) than did seronegative patients, and second primary tumors (n = 9 versus n = 0) occurred exclusively in seropositive patients. In total, therapy failures (recurrences, tumor-related deaths, second primaries) were observed in 17/38 cases (44.7%) in the p53-antibody-seropositive group and in 8/38 cases (21.1%) in the p53-antibody-seronegative group. These results, after a follow-up of 2 years, seem to indicate a prognostic value of p53 serum antibodies for therapy failure in patients with head and neck cancer.

Adult↗
PubMed1990

Prognostic indicators in patients with pulmonary metastases.

Pulmonary metastases from different primary neoplasms have different biological characteristics which may correlate with patient survival. Objective criteria to reliably select or exclude patients who would benefit from resection of these metastases are not available; however, various prognostic indicators have been studied for their correlation with post-resection survival. Prognostic indicators differ among various tumor histologies. Prognostic indicators identified preoperatively which may influence post-resection survival include age, sex, histology and location of the primary tumor, tumor doubling time, disease free interval, the number of nodules on preoperative roentgenographic studies, and the number of metastases resected. Following surgery, resectability, and the number of metastases resected may predict expected survival for patients meeting certain criteria. No single criterion should be used to exclude patients from surgery as resection will provide numerous patients with significant post-resection survival.

Age Factors↗
PubMed2005

Serum hemoglobin level determined at the first presentation is a poor prognostic indicator in patients with lung cancer.

OBJECTIVES: Anemia is observed in various malignancies including lung cancer and is recently considered to be a poor prognostic indicator. We investigated whether there is a correlation between anemia, other clinicopathologic factors, and survival. METHODS: We retrospectively examined the clinical records of 611 patients with lung cancer. RESULTS: Of those, 298 (48.8%) patients had anemia at the time of their first visit to our hospital. There was a significant correlation between anemia and age (p=0.0006) or ECOG performance status (p=0.0002), however, there was no correlation of anemia with gender, histological type, clinical stage, or serum level of lactate dehydrogenase. Survival was significantly shorter in 298 patients with anemia (median survival time (MST): 7.5 months) compared with 313 patients without anemia (MST: 11.8 months, p<0.0001). Multivariate analysis of prognostic factors using the Cox proportional hazards model revealed that anemia appeared to be an independent prognostic indicator. CONCLUSION: Anemia observed at the first presentation is an independent poor prognostic indicator in patients with lung cancer.

Adult↗
PubMed1975

Time factor as a prognostic indicator on the Bender-Gestalt test.

Z-scores from Bender-Gestalt records of 62 psychiatric in- and outpatients were computed. The patients were put on active treatment, and a psychiatric rating was done to evaluate therapeutic recovery after a period of 19 to 24 months. These patients were grouped into three categories, i.e., patients with low Z-scores and good therapeutic recovery; patients with high Z-scores and poor therapeutic recovery; patients with low Z-scores who still showed poor response to treatment. Total time taken by each patient to reprduce the BG designs was noted as well. Results indicate that Z-score was a significant prognostic indicator for schizophrenics, affective psychotics, organic psychotics and patients who were suffering from anxiety and conversion reactions, but not for obsessive compulsive neurotics. Time taken for BG reproductions proved to be an important prognostic indicator, as patients who did not respond satisfactorily to the treatment took significantly more time than those who responded well to treatment. Hence, time taken by the patients for BG reproductions also needs to be considered when any predictions are made with regard to therapeutic outcome.

Adolescent↗
PubMedDate not supplied

Protein tyrosine kinase activity in breast cancer and its relation to prognostic indicators.

Tyrosine kinase dependent oncogenes and growth factor receptors are of prognostic importance in breast cancer, but the relation of cytosolic protein tyrosine kinase (PTK) activity to traditional prognostic indicators is poorly defined. We determined cytosolic PTK activity in tumor extracts of 61 women with invasive breast cancer, including 51 primary specimens and 12 nodal or metastatic specimens, 7 women with in situ breast cancer, and 8 control breast specimens. PTK activity (pmol/min/mg) was measured in a dot blot assay using phosphotyrosine antibodies to detect phosphorylated tyrosyl residues in the tissue extracts. Compared with control specimens (mean PTK = 20.5), tyrosine kinase activity was significantly greater in invasive primary cancers (mean PTK = 298.1; p = 0.0008), and nodal/metastatic specimens (mean PTK = 491.5; p = 0.0009). PTK levels of invasive cancers did not correlate with age (p = 0.36), tumor size (p = 0.83), nodal status (p = 0.37), estrogen receptor status (p = 0.66), or progesterone receptor status (p = 0.09). Thus, while tyrosine kinase activity is increased in breast cancer, correlations with traditional prognostic indicators were not found.

Breast↗
PubMed1991

Preoperative prognostic indicators in cattle with abomasal volvulus.

A prospective study evaluating preoperative prognostic indicators in 80 cattle with abomasal volvulus was done. Surgical correction of the abomasal volvulus was performed in all animals. After surgery, cattle were categorized into 3 groups: productive (acceptable milk production or appetite, n = 59), salvaged (poor milk production or appetite, n = 10), and nonsurvivors (n = 11). Mean values for study variables did not differ significantly between salvaged and nonsurvivor groups. Cattle in these 2 groups were combined to form a nonproductive group, which was compared with the productive group. Productive cattle had a significantly lower preoperative heart rate than nonproductive cattle, were less dehydrated, had lower serum alkaline phosphatase (ALP) activity and serum creatinine concentration, more frequent rumen contractions, higher serum Na+ and Cl- concentrations, and had been inappetent for a shorter period. Significant differences were not detected in blood pH, base excess, anion gap, PCV, and serum K+ concentrations between the 2 groups. Feces from nonproductive cattle tended to be reduced in volume and were significantly darker. A number of preoperative prognostic indices were evaluated by calculating the sensitivity, specificity, and positive predictive value (+PV) of each variable and by using logistic regression. Positive predictive values were generally higher in identifying productive cattle than nonproductive cattle.(ABSTRACT TRUNCATED AT 250 WORDS)

Abomasum↗
PubMed1998

Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death.

OBJECTIVE: To investigate prognostic factors associated with mortality in patients with psoriatic arthritis (PsA). METHODS: Patients followed up at the Toronto PsA Clinic between 1978 and 1994 were included. Patients were reviewed at initial clinic entry and at 6-month intervals using a standard protocol. Data on deaths were collected in a prospective manner, and death certificates were used to identify the primary and antecedent cause(s) of death. All death information was recorded in the clinic's computerized database. Only factors that represented standard clinical measures of disease activity and progression were studied. The relationship between potential prognostic factors recorded at the time of the first clinic visit and the mortality rate was determined using the Cox relative risk regression model. RESULTS: There were 428 patients (234 men and 194 women), of whom 68% were known to be alive on September 1, 1994, 20% were lost to followup but assumed to be alive, and 12% had died. Multivariate analysis revealed that an erythrocyte sedimentation rate (ESR) > 15 mm/hour, medications used prior to initial clinic visit, radiologic damage, and the absence of nail lesions were associated with an increased overall mortality rate. There is some suggestion that prior medication use was least important for deaths associated with the circulatory system, while radiologic damage was particularly important for such deaths. A marked sex-associated effect was noted among deaths caused by injuries/poisoning, since 6 of the deaths occurred in men and only 1 was in a woman. CONCLUSION: Patients with PsA are at an increased risk of death compared with the general population. Evidence of previously active and severe disease, as manifested by the prior use of medications and by radiologic changes as well as an elevated ESR at presentation, are prognostic indicators for death. The presence of nail lesions appears to be a protective factor that has the most clinical importance in the context of previously active and severe disease.

Adolescent↗
PubMed1989

Peritoneal cytology as a prognostic indicator in endometrial carcinoma.

Among the prognostic indicators of endometrial carcinoma, the presence of cancer cells in peritoneal washings has been suggested as indicating a poor prognosis. This proposition was examined for 373 patients; positive peritoneal washings were observed in 20 of 335 patients with stage I disease and 10 of 29 with stages II-IV. In 13 of the 30 patients there was no gross evidence of disease. Within a follow-up period of two years, positive cytology appeared to be a sign of poor prognosis.

Cytological Techniques↗
PubMed1994

Cytoplasmic accumulation of p53 protein: an independent prognostic indicator in colorectal adenocarcinomas.

BACKGROUND: Aberrations of the p53 gene (also known as TP53) frequently lead to the synthesis of mutant proteins that accumulate in the nuclei and/or cytoplasm of neoplastic cells. Intracellular p53 protein accumulation may be an unfavorable prognostic parameter in breast, lung, ovarian, gastric, and colorectal cancers. Specific classes of p53 gene mutations, assayed by characteristic subcellular p53 protein accumulation patterns, may be useful prognostic indicators. PURPOSE: The prognostic value of nuclear and cytoplasmic p53 protein accumulation in the tumor cells of patients with colorectal carcinoma was studied. METHODS: Antibodies PAb 1801 and CM1 were used for immunocytochemical assay of nuclear and cytoplasmic p53 protein accumulation in a retrospective series of colorectal carcinoma samples obtained from 206 patients who were followed for at least 5 years. Results were correlated with the following clinicopathologic parameters: patient sex and age; tumor site, stage, and grade; and DNA ploidy status of the tumors. Overall survival and disease-free survival were analyzed with the Kaplan-Meier method. Differences in distributions were analyzed using the Mantel-Cox method. Multivariate analysis was performed with the Cox proportional hazards model. RESULTS: Immunostaining with PAb 1801 revealed nuclear p53 accumulation in 46% (95) of 206 cases, whereas CM1 immunostaining of 197 cases showed nuclear and cytoplasmic p53 accumulation in 33% (65 cases) and 50% (99 cases) of the cases, respectively. In univariate analysis, both nuclear p53PAb 1801 and cytoplasmic p53CM1 protein accumulations were significantly associated with poor overall survival (P = .0198 and P = .0017, respectively) and with disease-free survival (P = .004 and P = .0016, respectively). When patients were analyzed according to site of their tumors, nuclear p53PAb 1801 protein accumulation was statistically significant only in the right colon (P = .027), whereas cytoplasmic p53CM1 protein accumulation was statistically significant in the left colon and rectum (P = .0016). In multivariate analysis, only cytoplasmic p53CM1 protein accumulation was associated with poor overall survival and with disease-free survival (P = .006 and P = .002, respectively). With the addition of DNA ploidy status, however, cytoplasmic p53CM1 protein accumulation remained significant only for disease-free survival (P = .035). In patients with tumors of the left colon and rectum, cytoplasmic p53CM1 protein accumulation was the most significant prognostic indicator for overall survival (P = .007) and disease-free survival (P = .002) after disease stage. CONCLUSION: Cytoplasmic p53CM1 protein accumulation, but not nuclear p53PAb 1801 protein accumulation, is an independent prognostic parameter in patients with colorectal carcinomas. IMPLICATIONS: Cytoplasmic p53CM1 accumulation may be a useful indicator of patients at high risk for disease recurrence who may benefit from aggressive adjuvant therapy.

Adenocarcinoma↗
PubMed1998

Disease stage prognostic indices in the early clinical screening of colorectal cancer patients.

It is a truism to state that in cancer the extent to which the disease has spread (stage) is probably the most important factor determining patient prognosis and must be given prime consideration in evaluating and comparing different therapeutic regimes. Because of this, clinical screening tests (such as a rectal exam proctoscopy and colonoscopy), if tissue that is not normal is found, should include analyses contributing to the patient disease stage classification. However, the difficulty involved in this, principally due to the absence of reliable early prognostic indices of the disease stage, makes the cancer patients' treatment full of problems and risks. By a retrospective statistical study on pre-surgery peripheral blood immunological parameters of our groups of colorectal cancer patients and healthy subjects, we evaluated our previously suggested possibility of defining stage prognostic indices by parameter blood range values, evaluating their ability in the stage classification compared to the pTNM method. We have investigated the serum levels of various cytokines and cytokine receptors, leukocyte surface markers, peripheral blood mononuclear cell (PBMC) cytokine production and PBMC proliferative response. Statistically significant correlations between a variety of these immunological parameters and the disease stage were found, but as a clinical patient screening of all parameters is quite expensive, to identify the greatest stage weighting parameter and the respective blood range values, we performed a multivariate statistical analysis. We found that the blood ranges of IL-4 serum level and the PBMC proliferative response to anti-CD3 monoclonal antibody (mCD3) stimulus may be reliable prognostic indices which may contribute to an early disease stage classification in colorectal cancer patients, since they seem to be valid as the pTNM method. Moreover, as the immunological prognostic indices could be a useful tool to evaluate the patient immune response, they may also improve the definition of the patient's stage classification for the selection of treatment and restaging procedures for the evaluation of the treatment benefit and recurrent disease.

Adult↗
PubMed2004

HSP27 in patients with ovarian carcinoma: still an independent prognostic indicator at 60 months follow-up.

OBJECTIVE: Heat shock protein 27 (HSP27) is produced in response to pathophysiologic stress in animal cells. The authors have previously shown that HSP27 is an independent prognostic indicator in patients with ovarian carcinoma. The present study was performed to see whether HSP27 remained an independent prognostic indicator with longer follow-up. METHODS: One hundred and three consecutive patients with epithelial ovarian carcinoma were studied. Slides were prepared from fresh tissue. HPS27 staining was performed as previously described. Patient records were examined for FIGO stage, grade, histology, level of cytoreduction and survival. RESULTS: One hundred and three patients were followed for a mean of 60 months. Twenty patients had FIGO Stage I disease, four Stage II, 59 Stage III, and 20 Stage IV. Immunohistochemical (IHC) staining for HSP27 was not related to histologic grade, level of cytoreduction or histologic subtype. A statistically significant decrease in HSP27 staining was found to correlate with increased FIGO stage (p = 0.008). Using cox-regression analysis, HSP27 staining (p = 0.025), stage (p = 0.0012), and level of cytoreduction (p < 0.0001) were independent predictors of survival in these patients. CONCLUSION: Cox-regression analysis found HSP27 to be an independent indicator of prognosis and survival in patients with ovarian carcinoma who had longer follow-up. Decreased HSP27 staining was related to decreased survival. This study confirms the authors' earlier report on the importance of HSP27 as a prognostic indicator in ovarian carcinoma.

Adenocarcinoma, Clear Cell↗
PubMed1993

Combined determination of N-myc oncogene amplification and DNA ploidy in neuroblastoma. Complementary prognostic indicators.

BACKGROUND: N-myc gene amplification is a well-established prognostic indicator in neuroblastoma. Flow cytometric analysis of nuclear DNA content has shown that an abnormal nuclear DNA content in neuroblastoma is associated with a better prognosis. Because some patients with N-myc unamplified tumors have a poor prognosis, factors other than N-myc amplification may play a role in determining the clinical behavior of neuroblastoma. In the current study, the authors correlated N-myc gene amplification and flow cytometric nuclear DNA content with respect to prognosis. METHODS: Forty-one patients with neuroblastoma, including 15 screened patients, served as subjects. The copy number of the N-myc gene was determined by Southern blot analysis. DNA ploidy analysis was done on nuclei isolated from formalin-fixed, paraffin-embedded blocks. RESULTS: Of 40 specimens of neuroblastoma, 7 involved tumors containing amplification of the N-myc gene and 33 did not; 13 specimens showed DNA diploidy, and 27 showed DNA aneuploidy (including 4 with DNA tetraploidy). The Kaplan-Meier survival analysis indicated a significantly better prognosis in patients with unamplified N-myc tumors compared with those with N-myc amplified tumors (87.3% versus 28.6%, P < 0.05) and in patients with DNA aneuploid tumors compared with those with DNA diploid tumors (96.3% versus 43.0%, P < 0.001). The difference in the survival of the two extreme combinations, (e.g., 25 with N-myc unamplified and DNA aneuploidy [4 tetraploidy] versus 5 with N-myc amplified and DNA diploidy) was more significant (96.0% versus 20.0%, P < 0.001) than any other combination. CONCLUSION: Evaluations of N-myc gene amplification and DNA ploidy are complementary, and the combined determination of these two factors may be one of the most powerful prognostic indicators in neuroblastoma.

Child, Preschool↗
PubMed1988

Dietary fat in relation to prognostic indicators in breast cancer.

The relation of diet, especially fat intake, to recognized prognostic indicators for breast cancer was investigated in 666 women with a newly diagnosed infiltrating breast carcinoma. Diet during the year preceding diagnosis was assessed by interview using a food frequency questionnaire covering the intake of 114 food items. Prognostic indicators included axillary node involvement at diagnosis, estrogen receptor status, and selected histologic features of the primary tumor such as nuclear grade, histologic grade, tubule formation, mitotic activity, and nuclear size of tumor cells. After adjustment for total energy intake, age, body weight, and tumor size at diagnosis, an increase in saturated fat intake was related to an increased frequency of node involvement at diagnosis among postmenopausal patients. In contrast, an elevation in polyunsaturated fat intake was related to a reduction of the percentage of patients with positive nodes at diagnosis. This relation was observed among both premenopausal and postmenopausal patients. Dietary fat was not related to the estrogen receptor status of tumors. No association was found between dietary habits and histologic features of the primary tumor. These data suggest that dietary fat may have an effect on the growth or spread of breast cancer during the preclinical phase of the disease and that this effect may vary according to the type of fat considered.

Aged↗
PubMed2005

Prognostic indicators in peritoneal carcinomatosis from gastrointestinal cancer.

Peritoneal carcinomatosis from gastrointestinal cancer has new treatment options for surgical management. The approach uses cytoreductive surgery which combines peritonectomy and visceral resection in an effort to remove all visible cancer within the abdomen and pelvis. Then the peritoneal cavity is flooded with chemotherapy solution in an attempt to eradicate residual disease. In order to select patients for this approach the quantitative prognostic indicators for carcinomatosis were reviewed, compared and contrasted. Prognostic indicators to be used to select patients for this aggressive approach at the initiation of surgery and after completion of cytoreduction were studied. Four quantitative assessments to be used at the time of abdominal exploration were the Gilly staging, Japanese gastric cancer P score, peritoneal cancer index (PCI), and the simplified peritoneal cancer index (SPCI). All have value with the PCI being the most validated and most precise. Preoperative assessments include the tumor histopathology and the prior surgical score. The completeness of cytoreduction score is an assessment of residual disease after a maximal surgical effort. An opportunity for long-term survival following treatment for carcinomatosis requires a complete cytoreduction in all reports for gastrointestinal cancer. Quantitative prognostic indicators need to be knowledgeably employed when patients with carcinomatosis are being treated. Improved patient selection with greater benefit and reduced morbidity and mortality should result.

Journal Article↗
PubMed1990

Radiation associated eosinophilia and monocytosis in carcinoma of the uterine cervix: a simple reliable clinical and prognostic indicator.

Clinical and prognostic significance of radiation associated eosinophilia (RAE) and radiation associated monocytosis (RAM) was evaluated in 176 patients with squamous cell carcinoma of the uterine cervix followed up after radiotherapy. Significant RAE was noticed in patients with Stages I/IIA and IIB who remained disease-free after treatment. On the contrary, patients belonging to these two stages but who developed recurrent disease showed absence of RAE. These patients as well as those belonging to Stage III showed considerably higher levels of RAM as compared to those patients remaining disease-free. These observations showed the usefulness of these two simple inexpensively carried out parameters in prognosticating disease course in malignant cervical neoplasia.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Prognostic indicators for dogs with dilated cardiomyopathy.

The purpose of this study was to investigate the prognostic value of various clinical, ECG, echocardiographic, and Doppler echocardiographic variables in dogs with dilated cardiomyopathy. The relationship to survival of 11 variables was evaluated in 63 dogs. Studied variables were age at time of diagnosis, class of heart failure (HF), dyspnea, ascites, atrial fibrillation (AF), ejection fraction (EF), E-point septal separation, end-diastolic volume index, end-systolic volume index (ESV-I), and restrictive or nonrestrictive transmitral flow (TMF) pattern. Median survival time was 671 days (lower 95% confidence limit, 350 days). Survival curves showed that severity of HF, ascites, ESV-I greater than 140 mL/m2, EF less than 25%, and restrictive TMF pattern had a significant negative relation to survival time. Thirty-nine dogs with both sinus rhythm and AF presented adequate TMF recordings; in these dogs, after stratification by TMF pattern, the restrictive TMF pattern was the most important negative prognostic indicator. We conclude that in dogs with dilated cardiomyopathy the restrictive TMF pattern appears to represent a useful prognostic indicator. Class of HF, ascites, ESV-I, and EF are also useful indexes if an adequate TMF pattern is not recorded.

Animals↗