Dilated Cardiomyopathy: A Comprehensive Approach to Diagnosis and Risk Stratification.
André FerreiraVera Vaz FerreiraMiguel Marques AntunesAna LousinhaTiago Pereira SilvaDiana AntunesPedro Silva CunhaMário OliveiraRui Cruz FerreiraSílvia Aguiar RosaPublished in: Biomedicines (2023)
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.
Keyphrases
- heart failure
- left ventricular
- magnetic resonance
- decision making
- end stage renal disease
- cardiac resynchronization therapy
- newly diagnosed
- ejection fraction
- chronic kidney disease
- atrial fibrillation
- blood pressure
- stem cells
- acute heart failure
- type diabetes
- risk factors
- prognostic factors
- ischemia reperfusion injury
- adipose tissue
- computed tomography
- gene expression
- depressive symptoms
- cardiovascular disease
- sleep quality
- replacement therapy
- mass spectrometry
- blood brain barrier
- fluorescence imaging
- contrast enhanced
- physical activity