Dilated cardiomyopathy

Heinz-Peter Schultheiss, DeLisa Fairweather, Alida L P Caforio, Felicitas Escher, Ray E Hershberger, Steven E Lipshultz, Peter P Liu, Akira Matsumori, Andrea Mazzanti, John McMurray, Silvia G Priori

Research output: Contribution to journalReview article

Abstract

Dilated cardiomyopathy (DCM) is a clinical diagnosis characterized by left ventricular or biventricular dilation and impaired contraction that is not explained by abnormal loading conditions (for example, hypertension and valvular heart disease) or coronary artery disease. Mutations in several genes can cause DCM, including genes encoding structural components of the sarcomere and desmosome. Nongenetic forms of DCM can result from different aetiologies, including inflammation of the myocardium due to an infection (mostly viral); exposure to drugs, toxins or allergens; and systemic endocrine or autoimmune diseases. The heterogeneous aetiology and clinical presentation of DCM make a correct and timely diagnosis challenging. Echocardiography and other imaging techniques are required to assess ventricular dysfunction and adverse myocardial remodelling, and immunological and histological analyses of an endomyocardial biopsy sample are indicated when inflammation or infection is suspected. As DCM eventually leads to impaired contractility, standard approaches to prevent or treat heart failure are the first-line treatment for patients with DCM. Cardiac resynchronization therapy and implantable cardioverter-defibrillators may be required to prevent life-threatening arrhythmias. In addition, identifying the probable cause of DCM helps tailor specific therapies to improve prognosis. An improved aetiology-driven personalized approach to clinical care will benefit patients with DCM, as will new diagnostic tools, such as serum biomarkers, that enable early diagnosis and treatment.

Original languageEnglish
Pages (from-to)32
JournalNature Reviews Disease Primers
Volume5
Issue number1
DOIs
Publication statusPublished - May 9 2019

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    Schultheiss, H-P., Fairweather, D., Caforio, A. L. P., Escher, F., Hershberger, R. E., Lipshultz, S. E., Liu, P. P., Matsumori, A., Mazzanti, A., McMurray, J., & Priori, S. G. (2019). Dilated cardiomyopathy. Nature Reviews Disease Primers, 5(1), 32. https://doi.org/10.1038/s41572-019-0084-1