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Dilated cardiomyopathy

Robert G Weintraub1, Christopher Semsarian2, Peter Macdonald3

  • 1Department of Cardiology, Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.

Lancet (London, England)
|February 14, 2017
PubMed

Insights

Dilated cardiomyopathy involves enlarged left ventricles and poor pumping function, often caused by genetics or acquired factors. Treatment focuses on managing heart failure symptoms and preventing sudden death.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Dilated cardiomyopathy (DCM) is characterized by left ventricular enlargement and impaired contractility.
  • Genetic mutations (cytoskeletal, sarcomere, nuclear envelope proteins) cause up to 35% of DCM cases.
  • Acquired causes include myocarditis, toxins, and metabolic/endocrine issues.

Purpose of the Study:

  • To define dilated cardiomyopathy and outline its causes, symptoms, and current treatment strategies.
  • To highlight the prognostic factors and emerging therapeutic investigations in DCM.

Main Methods:

  • Review of existing literature on dilated cardiomyopathy.
  • Analysis of genetic and acquired etiologies.
  • Summary of clinical presentation, diagnostic indicators, and therapeutic interventions.

Main Results:

  • DCM presents with symptoms of congestive heart failure, arrhythmias, or circulatory collapse.
  • Prognosis is linked to ejection fraction and diastolic dysfunction severity.
  • Standard treatments include ACE inhibitors and beta-blockers for chronic heart failure.

Conclusions:

  • Effective management of dilated cardiomyopathy involves addressing heart failure, arrhythmias, and sudden death risk.
  • Multidisciplinary care, device therapy, and advanced treatments like mechanical support or transplantation are crucial for refractory cases.
  • Ongoing research explores preclinical disease treatment and stem cell therapy's potential role.

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