Clinical management of dilated cardiomyopathy: current knowledge and future perspectives

Merlo, Marco; Cannatà, Antonio; Vitagliano, Alice; Zambon, Elena; Lardieri, Gerardina; Sinagra, Gianfranco

doi:10.1586/14779072.2016.1125292

Cited by 23 publications

(19 citation statements)

References 25 publications

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“…DCM has been considered for a long time as an invariably irreversible condition. The cumulative experience derived from referral centers revealed that almost 40% of DCM patients under optimal medical and device treatments experience a significant left ventricular reverse remodeling [2][3][4]9]. Optimal management of DCM is largely based on conventional therapy of systolic heart failure, according to current guidelines [10].…”

Section: Dcm As a Dynamic Disease: The Importance Of Follow-upmentioning

confidence: 99%

“…Therefore, echocardiographic evaluation of patients affected by DCM should be as much accurate as possible, beyond LV systolic function and dimensions, both at baseline and during follow-up. Newer noninvasive techniques assessing myocardial deformation (e.g., speckle-tracking echocardiography or CMR-derived strain) have greater sensitivity than Left Ventricular Ejection Fraction (LVEF) for identifying subclinical abnormalities of systolic function and may assume a role in the early detection of disease [2,3,25].…”

Section: Left Ventricular Reverse Remodeling Beyond the Left Ventriclementioning

confidence: 99%

“…Cardiopulmonary exercise test (CPET), using peak of oxygen consumption, has driven the optimal timing for the selection of heart transplant candidates [26]. Due to the advances in knowledge of exercise impairment in HF, new indexes have been proposed, including the percentage of predicted peak VO 2 , peak systolic blood pressure, and ventilatory efficiency, expressed as VE/VCO 2 slope [2,3,[27][28][29]. Notably, patients affected by DCM perform better at CPET compared to other etiologies of HF due to their intrinsic characteristics; therefore the abovementioned markers need further future validation in DCM.…”

Section: Prognostic Role Of Cardiopulmonary Exercise Testingmentioning

confidence: 99%

“…Yet from the early 1990s, significant improvements in prognosis of DCM patients have been achieved. Indeed, the yearly incidence of adverse events, death, or heart transplantation has been dramatically reduced to less than 2% per year, the incidence of sudden cardiac death (SCD) less than 0.5% per year, and a survival free from transplantation more than 87% at 8 years of follow-up [3,4]. All these achievements are mainly due to several milestones reached in the management of DCM patients.…”

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confidence: 99%

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Prognostic Stratification and Importance of Follow-Up

Cannatà

Stolfo

Merlo

et al. 2019

Dilated Cardiomyopathy

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Section: Dcm As a Dynamic Disease: The Importance Of Follow-upmentioning

confidence: 99%

Section: Left Ventricular Reverse Remodeling Beyond the Left Ventriclementioning

confidence: 99%

Section: Prognostic Role Of Cardiopulmonary Exercise Testingmentioning

confidence: 99%

mentioning

confidence: 99%

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Prognostic Stratification and Importance of Follow-Up

Cannatà

Stolfo

Merlo

et al. 2019

Dilated Cardiomyopathy

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“…In addition, different clinical contexts were assessed, and should be taken into consideration (72). As put forward by Doesch et al, different risk factors play a role in distinct cardiac disorders (namely DCM and ICM) (12), a fact that has been previously highlighted (73). Also, the fact that medication could affect its values is worth considering in future research (41,48).…”

Section: Study Limitationsmentioning

confidence: 99%

Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Vilela¹,

Bettencourt‐Silva²,

Costa³

et al. 2017

Ann. Transl. Med.

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Anti-cardiac troponin antibodies have been studied in different types of clinical diseases and in healthy populations. A systematic review of published data on anti-troponin antibodies was carried out (search performed on PubMed, ISI Web of Knowledge and Scopus databases). From title and abstract analysis, thirty-three articles were included that met the pre-specified criteria; after full-text analysis, nine articles were excluded. Most studies assessed anti-troponin I antibodies. The prevalence of anti-cardiac troponin antibodies in healthy individuals ranged from 0.0% to 20.0%. The prevalence of anti-troponin I autoantibodies in dilated cardiomyopathy (DCM) ranged from 7.0% to 22.2%. Other conditions under study were myocardial infarction, ischemic cardiomyopathy (ICM), peripartum cardiomyopathy (PPCM), Chagas disease, Emery-Dreifuss muscular dystrophy (EDMD) and renal transplantation. In the different patient populations studied, anti-cardiac troponin antibodies have been shown to be either positively or negatively associated with prognostic and clinical features. In what concerns a possible value as biomarkers, these assays have not emerged up to the present moment as important aids for practical clinical decisions in cardiac or other types of patients. In what concerns pathophysiology, anti-cardiac troponin autoantibodies may play a role in different diseases. It can be speculated that these antibodies could be involved in perpetuating some degree of cardiac injury after an event, such as myocardial infarction or PPCM. The major function of the heart is its contractile function, and cardiac muscle contains sarcomeres, which include different types of molecules, of which actin and myosin are essential for strength generation during contraction. Other molecules, such as cardiac troponins, play a role of regulation concerning cardiac muscle contraction. Cardiac troponins I and T have been shown to be different molecules than the corresponding ones in skeletal muscle, and have gained importance as cardiac biomarkers (1,2).Research has shown that antibodies against cardiac troponins exist in different settings, and questions about their role in the cardiovascular pathological continuum have emerged over the last years. The possible role of cardiac troponin autoantibodies in disease processes [and particularly in dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM)] has gained interest (3-6).Animal models in mice have demonstrated that anticardiac troponin I autoantibodies are capable of inducing heart dilatation and dysfunction, apparently through interactions with the calcium balance in cardiomyocytes (7). Okazaki et al. showed that in mice antibodies to cardiac troponin I stained the surface of cardiomyocytes, implying the presence of troponin I on the cell surface (differing from cardiac troponin T) (7). Göser et al. immunized mice with cardiac troponin I, leading to severe inflammation of the myocardium, cardiomegaly, fibrosis and 30% mortality over 270 days (8). However, in a study carri...

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Stem cell therapy for dilated cardiomyopathy

Díaz-Navarro

Urrútia

Cleland

et al. 2019

Cochrane Database of Systematic Reviews

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We are uncertain whether SCT in people with DCM reduces the risk of all-cause mortality and procedural complications, improves HRQoL, and performance status (exercise capacity). SCT may improve functional class (NYHA), compared to usual care (no cells).Similarly, when compared to G-CSF, we are also uncertain whether SCT in people with DCM reduces the risk of all-cause mortality although some studies within this comparison observed a favourable e ect that should be interpreted with caution. SCT may not improve HRQoL but may improve to some extent performance status (exercise capacity). Very low-quality evidence reflects uncertainty regarding procedural complications. These suggested beneficial e ects of SCT, although uncertain due to the very low certainty of the evidence, are accompanied by favourable e ects on some physiological measures of cardiac function.Presently, the most e ective mode of administration of SCT and the population that could benefit the most is unclear. Therefore, it seems reasonable that use of SCT in people with DCM is limited to clinical research settings. Results of ongoing studies are likely to modify these conclusions.

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Clinical management of dilated cardiomyopathy: current knowledge and future perspectives

Cited by 23 publications

References 25 publications

Prognostic Stratification and Importance of Follow-Up

Prognostic Stratification and Importance of Follow-Up

Anti-cardiac troponin antibodies in clinical human disease: a systematic review

Stem cell therapy for dilated cardiomyopathy

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