Related Experiment Videos

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

Aikaterini-Eleftheria Karanikola1, Ioannis Doundoulakis1, Christos-Konstantinos Antoniou1

  • 1First Cardiology Department, National and Kapodistrian University of Athens, Hippokration General Hospital, 11527 Athens, Greece.

Reviews in Cardiovascular Medicine
|July 31, 2026
PubMed

Insights

Dilated cardiomyopathy (DCM) patients face high sudden cardiac death (SCD) risk from ventricular arrhythmias. A multiparametric approach, integrating various tests, offers a personalized strategy for better SCD outcomes.

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.

Keywords:
dilated cardiomyopathygenetic testingmagnetic resonance imagingrisk assessmentsudden cardiac deathventricular tachycardia

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...