Dilated cardiomyopathy

Summary Dilated cardiomyopathy is characterised by left ventricular dilation that is associated with systolic dysfunction. Diastolic dysfunction and impaired right ventricular function can develop. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms...

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Bibliographic Details
Published in:The Lancet (British edition) 2010-02, Vol.375 (9716), p.752-762
Main Authors: Jefferies, John Lynn, MD, Towbin, Jeffrey A, Prof
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers
Cardiac arrhythmia
Cardiology
Cardiology. Vascular system
Cardiomyopathy, Dilated - diagnosis
Cardiomyopathy, Dilated - epidemiology
Cardiomyopathy, Dilated - genetics
Cardiomyopathy, Dilated - physiopathology
Cardiomyopathy, Dilated - therapy
Cardiovascular disease
Diagnosis, Differential
Echocardiography
Electrocardiography
Exercise Tolerance
General aspects
Heart
Heart attacks
Heart failure
Heart Failure - diagnosis
Heart Failure - epidemiology
Heart Failure - genetics
Heart Failure - therapy
Humans
Infection - complications
Internal Medicine
Medical sciences
Myocardial Contraction - genetics
Myocarditis - complications
Myocarditis - diagnosis
Myocarditis - genetics
Myocarditis. Cardiomyopathies
Prognosis
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - epidemiology
Ventricular Dysfunction, Left - genetics
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Summary:Summary Dilated cardiomyopathy is characterised by left ventricular dilation that is associated with systolic dysfunction. Diastolic dysfunction and impaired right ventricular function can develop. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms can be exercise-induced or persistent at rest. Many patients are asymptomatic. Chronically treated patients sometimes present acutely with decompensated heart failure. Other life-threatening risks are ventricular arrhythmias and atrioventricular block, syncope, and sudden death. Genetic inheritance arises in 30–48% of patients, and inflammatory disorders such as myocarditis or toxic effects from medications, alcohol, or illicit drugs also result in dilated cardiomyopathy. Genes that cause dilated cardiomyopathy generally encode cytoskeletal and sarcomeric (contractile apparatus) proteins, although disturbance of calcium homeostasis also seems to be important. In children, disrupted mitochondrial function and metabolic abnormalities have a causal role. Treatments focus on improvement of cardiac efficiency and reduction of mechanical stress. Arrhythmia therapy and prevention of sudden death continue to be mainstays of treatment. Despite progress over the past 10 years, outcomes need to be improved.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(09)62023-7