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Published on: May 16, 2020
A Comprehensive Outlook on Dilated Cardiomyopathy (DCM): State-Of-The-Art Developments with Special Emphasis on
Vivek Sarohi1,2, Shriya Srivastava1, Trayambak Basak1,2
1Indian Institute of Technology (IIT)-Mandi, School of Basic Sciences (SBS), Mandi 175075, HP, India.
Insights
Dilated cardiomyopathy (DCM), a heart failure cause, involves ventricle dilation and dysfunction. This review explores DCM
Area of Science:
- Cardiology
- Genetics
- Biomarker Discovery
Background:
- Dilated cardiomyopathy (DCM) is a major cause of heart failure, characterized by ventricular dilation and impaired myocardial contractility.
- While genetic factors are implicated, the etiology of DCM remains elusive in many cases, with a significant idiopathic proportion.
- DCM progression leads to heart failure, a growing global health concern, particularly in India.
Purpose of the Study:
- To provide a comprehensive overview of dilated cardiomyopathy (DCM), including its symptoms, causes, genetic basis, and progression.
- To summarize current diagnostic methods, biomarkers, treatments, and clinical trials for DCM.
- To highlight the potential of omics-based technologies for identifying novel biomarkers in DCM, with a focus on Indian patients.
Main Methods:
- Review of existing literature on DCM, covering genetic studies, clinical manifestations, and treatment strategies.
- Analysis of diagnostic approaches and current therapeutic regimens for DCM.
- Introduction of systems-level studies using mass-spectrometry-based clinical proteomics and lipidomics in Indian DCM patients.
Main Results:
- Candidate-gene studies have identified mutations in cardiac protein genes contributing to DCM.
- A significant portion of DCM cases remain idiopathic, underscoring the need for further etiological research.
- Next-generation omics technologies offer promise for discovering novel proteomic and lipidomic biomarkers for improved DCM management.
Conclusions:
- Dilated cardiomyopathy (DCM) is a complex cardiovascular disease with diverse etiologies, necessitating a holistic understanding of its mechanisms.
- Improved prognostic biomarkers are crucial for managing DCM-mediated heart failure.
- Systems-level omics approaches, particularly in diverse populations like India, are essential for advancing DCM research and patient care.
Abstract:
Dilated cardiomyopathy (DCM) remains an enigmatic cardiovascular disease (CVD) condition characterized by contractile dysfunction of the myocardium due to dilation of the ventricles. DCM is one of the major forms of CVD contributing to heart failure. Dilation of the left or both ventricles with systolic dysfunction, not explained by known causes, is a hallmark of DCM. Progression of DCM leads to heart failure. Genetic and various other factors greatly contribute to the development of DCM, but the etiology has still remained elusive in a large number of cases. A significant number of studies have been carried out to identify the genetic causes of DCM. These candidate-gene studies revealed that mutations in the genes of the fibrous, cytoskeletal, and sarcomeric proteins of cardiomyocytes result in the development of DCM. However, a significant proportion of DCM patients are idiopathic in nature. In this review, we holistically described the symptoms, causes (in adults and newborns), genetic basis, and mechanistic progression of DCM. Further, we also summarized the state-of-the-art diagnosis, available biomarkers, treatments, and ongoing clinical trials of potential drug regimens. DCM-mediated heart failure is on the rise worldwide including in India. The discovery of biomarkers with a better prognostic value is the need of the hour for better management of DCM-mediated heart failure patients. With the advent of next-generation omics-based technologies, it is now possible to probe systems-level alterations in DCM patients pertaining to the identification of novel proteomic and lipidomic biomarkers. Here, we also highlight the onset of a systems-level study in Indian DCM patients by applying state-of-the-art mass-spectrometry-based "clinical proteomics" and "clinical lipidomics".
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