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- Title
Dilated cardiomyopathy: from epidemiologic to genetic phenotypes: A translational review of current literature.
- Authors
Reichart, D.; Magnussen, C.; Zeller, T.; Blankenberg, S.
- Abstract
Dilated cardiomyopathy (DCM) is characterized by left ventricular dilatation and, consecutively, contractile dysfunction. The causes of DCM are heterogeneous. DCM often results from myocarditis, exposure to alcohol, drugs or other toxins and metabolic or endocrine disturbances. In about 35% of patients, genetic mutations can be identified that usually involve genes responsible for cytoskeletal, sarcomere and nuclear envelope proteins. Due to its heterogeneity, a detailed diagnostic work-up is necessary to identify the specific underlying cause and exclude other conditions with phenotype overlap. Patients with DCM show typical systolic heart failure symptoms, but, with progress of the disease, diastolic dysfunction is present as well. Depending on the underlying pathology, DCM patients also become apparent through arrhythmias, thromboembolic events or cardiogenic shock. Disease progression and prognosis are mostly driven by disease severity and reverse remodelling within the heart. The worst prognosis is seen in patients with lowest ejection fractions or severe diastolic dysfunction, leading to terminal heart failure with subsequent need for left ventricular assist device implantation or heart transplantation. Guideline-based heart failure medication and device therapy reduces the frequency of heart failure hospitalizations and improves survival.
- Subjects
DILATED cardiomyopathy; HEART assist devices; NUCLEAR membranes; HEART failure; LITERATURE reviews
- Publication
Journal of Internal Medicine, 2019, Vol 286, Issue 4, p362
- ISSN
0954-6820
- Publication type
journal article
- DOI
10.1111/joim.12944