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Influence of different aetiologies on clinical course and outcome in patients with dilated cardiomyopathy

Sabine Pankuweit1, Claus Lüers2, Anette Richter1

  • 1Department of Internal Medicine - Cardiology, Angiology, Intensive Care and Prevention, University of Marburg, Marburg, Germany.

European Journal of Clinical Investigation
|June 23, 2015
PubMed

Insights

Early diagnosis of dilated cardiomyopathy (DCM) significantly improves patient outcomes. Patients diagnosed within one year show greater improvement in heart function and New York Heart Association class compared to those diagnosed later.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Heart Failure Research

Background:

  • Dilated cardiomyopathy (DCM) is a complex heart condition often considered an end-stage disease.
  • A subset of DCM patients have inflammatory cardiomyopathy (DCMi/v) with unclear etiology.
  • Understanding the impact of diagnosis timing on DCM outcomes is crucial.

Purpose of the Study:

  • To investigate the association between the time of heart failure diagnosis and clinical outcomes in patients with dilated cardiomyopathy.
  • To compare the clinical course of patients with early (≤1 year) versus late (>1 year) diagnosis of DCM and inflammatory DCM (DCMi/v).

Main Methods:

  • A cohort of 237 patients with DCM and DCMi/v were re-examined after a 1-year follow-up.
  • Clinical work-up included assessment of New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF).
  • Patients were categorized into newly diagnosed (≤1 year) and late diagnosed (>1 year) groups.

Main Results:

  • All patients showed significant improvements in NYHA class and LVEF after 1 year.
  • Newly diagnosed DCM patients experienced a greater reduction in NYHA class (-0.48) compared to late diagnosed patients (-0.24).
  • Newly diagnosed DCMi/v patients showed a marked improvement in NYHA class (-0.82) versus late diagnosed DCMi/v patients (-0.17).
  • Left ventricular ejection fraction improved significantly in both newly and late diagnosed groups, with a more pronounced increase in newly diagnosed patients.

Conclusions:

  • Early diagnosis of DCM within one year of symptom onset is associated with significantly better clinical outcomes.
  • Late diagnosis of DCM is linked to a diminished improvement in clinical course and overall outcome.
  • This study highlights the critical importance of timely diagnosis for managing dilated cardiomyopathy effectively.
Abstract

Keywords:
Aetiologydilated cardiomyopathyepidemiologyheart failureinflammationmyocarditis

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