Dilated Cardiomyopathy: A Comprehensive Approach to Diagnosis and Risk Stratification

Dilated cardiomyopathy (DCM) represents one of the most common causes of non-ischemic heart failure, characterised by ventricular dilation alongside systolic dysfunction. Despite advances in therapy, DCM mortality rates remain high, and it is one of the leading causes of heart transplantation. It wa...

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Bibliographic Details
Published in:Biomedicines 2023-03, Vol.11 (3), p.834
Main Authors: Ferreira, André, Ferreira, Vera, Antunes, Miguel Marques, Lousinha, Ana, Pereira-da-Silva, Tiago, Antunes, Diana, Cunha, Pedro Silva, Oliveira, Mário, Ferreira, Rui Cruz, Rosa, Sílvia Aguiar
Format: Article
Language:English
Subjects:
arrhythmogenic left ventricle cardiomyopathy
Cardiac arrhythmia
Cardiomyopathy
Cardiomyopathy, Dilated
Cardiovascular disease
cardiovascular magnetic resonance
Congestive heart failure
Coronary vessels
Decision making
Differential diagnosis
Dilated cardiomyopathy
Etiology
Genetic screening
genetic testing
Genotype & phenotype
Heart failure
Heart transplantation
Ischemia
Metabolism
Morphology
Mutation
Myocarditis
Patients
Phenotypes
Physiological aspects
reverse remodelling
Review
risk stratification
Ventricle
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Summary:Dilated cardiomyopathy (DCM) represents one of the most common causes of non-ischemic heart failure, characterised by ventricular dilation alongside systolic dysfunction. Despite advances in therapy, DCM mortality rates remain high, and it is one of the leading causes of heart transplantation. It was recently recognised that many patients present minor structural cardiac abnormalities and express different arrhythmogenic phenotypes before overt heart-failure symptoms. This has raised several diagnostic and management challenges, including the differential diagnosis with other phenotypically similar conditions, the identification of patients at increased risk of malignant arrhythmias, and of those who will have a worse response to medical therapy. Recent developments in complementary diagnostic procedures, namely cardiac magnetic resonance and genetic testing, have shed new light on DCM understanding and management. The present review proposes a comprehensive and systematic approach to evaluating DCM, focusing on an improved diagnostic pathway and a structured stratification of arrhythmic risk that incorporates novel imaging modalities and genetic test results, which are critical for guiding clinical decision-making and improving outcomes.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines11030834