Redefining Sudden Cardiac Death Risk Stratification in Dilated Cardiomyopathy: An Integrative Approach

Area of Science:

• Cardiology
• Genetics
• Medical Imaging

Background:

• Dilated cardiomyopathy (DCM) is a common heart condition.
• Sudden cardiac death (SCD) is a major cause of mortality in DCM patients, often due to ventricular arrhythmias (VAs).
• Current risk stratification primarily uses left ventricular ejection fraction (LVEF) for implantable cardioverter-defibrillator (ICD) decisions.

Purpose of the Study:

• To review established and emerging tools for SCD risk stratification in DCM.
• To highlight limitations of single-parameter risk assessment.
• To discuss future directions for personalized, dynamic SCD risk evaluation.

Main Methods:

• Literature review of current evidence on SCD risk stratification in DCM.
• Analysis of multiparametric strategies integrating clinical, ECG, biomarker, CMR, genetic, and electrophysiological data.
• Discussion of limitations and future prospects.

Main Results:

• Left ventricular ejection fraction (LVEF) is a primary but insufficient predictor of SCD risk.
• Multiparametric strategies incorporating diverse data show promise for improved risk assessment.
• Emerging tools and personalized approaches are needed to optimize SCD outcomes.

Conclusions:

• Current SCD risk stratification in DCM has limitations, particularly single-parameter reliance.
• A comprehensive, multiparametric approach is essential for accurate risk assessment.
• Future research should focus on personalized and dynamic risk models to improve patient management and reduce SCD mortality.