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Genetic Testing as a Guide for Treatment in Dilated Cardiomyopathies
Soledad García-Hernandez1,2, Lorenzo Monserrat Iglesias3
1Scientific Department, Health in Code S.L., A Coruña, Spain.
Insights
Genetic testing for dilated cardiomyopathy (DCM) is cost-effective, aiding diagnosis and risk stratification. Identifying genetic causes enables personalized treatments and understanding disease progression.
Area of Science:
- Cardiology
- Genetics
- Precision Medicine
Background:
- Dilated cardiomyopathy (DCM) is a primary cardiomyopathy with diverse genetic and non-genetic causes.
- DCM can represent a common endpoint for other cardiomyopathies.
- Understanding genetic substrates is crucial for diagnosis and management.
Purpose of the Study:
- Review main genetic substrates in DCM.
- Discuss genotype-phenotype correlations.
- Explore genetic testing's role in risk stratification and precision medicine.
Main Methods:
- Comprehensive genetic studies in DCM patients.
- Analysis of genotype-phenotype relationships.
- Review of current literature on genetic testing and precision medicine.
Main Results:
- Genetic studies yield up to 40% diagnostic rate in DCM.
- Genetic findings impact clinical management, familial screening, and risk stratification.
- Identification of genetic substrates facilitates understanding disease natural history.
Conclusions:
- Genetic testing is a cost-effective diagnostic tool for DCM.
- Genotype-based approaches are advancing precision medicine for DCM.
- Targeting-gene therapies show promise for future DCM treatment.
Purpose Of Review:
Dilated cardiomyopathy (DCM) is one of the most prevalent primary cardiomyopathies and may be caused by genetic and non-genetic etiologies. DCM may also be the final common pathway of other cardiomyopathies such as hypertrophic, arrhythmogenic, or non-compaction cardiomyopathy. We review the main DCM genetic substrates, specific genotype-phenotype aspects, the role of genetic testing in risk stratification, and advances regarding genotype-based precision medicine.
Recent Findings:
Performing a comprehensive genetic study could have a diagnostic yield up to 40% in DCM, and it is considered a cost-effective approach nowadays. The detection of a specific underlying genetic substrate explaining the disease can have important consequences for clinical management, especially for familial cascade screening, optimizing medical treatment, and improving the arrhythmic risk stratification. The identification of the genetic substrate underlying dilated cardiomyopathy makes possible the genotype-phenotype correlation analysis and a better understanding of the natural history of this disease. Nowadays, there are many promising targeting-gene therapies in different developing phases.
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