Ischemic and non-ischemic dilated cardiomyopathy

Abstract

<jats:title>Abstract</jats:title><jats:p>Dilated Cardiomyopathy is a high-incident disease, which diagnosis of and treatments are clinical priority. The aim of our study was to evaluate the diagnostic potential of cardiac magnetic resonance (CMR) imaging; echocardiography and the biochemical parameters that can help us differentiate between the post-ischemic and non-ischemic dilated cardiomyopathy. Materials and methods. The study enrolled 134 patients with dilated cardiomyopathy: 74 with the post-ischemic form and 60 with the non-ischemic one. All patients underwent a coronary imaging test, with echocardiogram, cardiac magnetic resonance and a blood test. Pro-inflammatory cytokines were evaluated using Luminex kit. Data was compared between the two groups. Results. Echocardiography allowed recognition of Left Ventricular Non Compaction in 2 patients. Longitudinal and circumferential strains were significantly different in the two groups (p&lt;0.05). Using CMR imaging a post-myocarditis scar was diagnosed in 2 patients and a post-ischemic scar in 95% of patients with the chronic ischemic disease. The interleukin IL-1, IL-6 and TNF-α levels were higher in the post-ischemic group compared with the non-ischemic one. Conclusions. The use of second level techniques with a high sensitivity and specificity would help distinguish among different sub-forms of dilated cardiomyopathy.</jats:p>

Inflammation-Related Biomarkers Are Associated with Heart Failure Severity and Poor Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy

“…In addition, the prognostic role of IL-6 and TNF-α in chronic heart failure patients has been demonstrated in previous studies [50,51]. However, approximately half of these cohorts were composed of ischemic heart failure patients, which might have had a significant impact on the predictive value of these cytokines, considering that serum concentrations of IL-6 and TNF-α are significantly higher in ischemic heart failure patients than in patients with NI-DCM [9,10]. To the best of our knowledge, the prognostic value of IL-6 and TNF-α has not previously been estimated in a NI-DCM patient population.…”

“…However, this population consists of multi-etiologic diseases, primarily NI-DCM and ischemic heart disease. Ischemic heart disease patients stand out not just because of a poorer prognosis than patients with non-ischemic heart failure [7,8] but also due to a higher expression and concentration of inflammation-related biomarkers [9][10][11]. Thus, the prognostic role of inflammation-related biomarkers in chronic heart failure studies might be primarily determined by patients with ischemic etiology.…”

Psychosomatic syndromes are associated with IL-6 pro-inflammatory cytokine in heart failure patients

“…Inflammatory activity may be one potential mechanism, given that research shows that heart failure patients have higher levels of proinflammatory cytokines as compared to healthy controls [ 22 – 25 ] and pro-inflammatory cytokines, such as IL-6 and TNF-alpha, have been identified as prognostic markers in HF [ 26 – 29 ]. Particularly, the levels of cytokines (e.g., IL-6, TNF-alpha) have been found higher in in patients with ischemic cardiomyopathy when compared with patients with non-ischemic cardiomyopathy [ 30 ].…”

The circulating level of interleukins 6 and 18 in ischemic and idiopathic dilated cardiomyopathy

“…Dilated cardiomyopathy (DCM), a leading cause of heart failure, is a relatively high-incident disease, considered as the final response of myocardium to a diverse group of genetic and environmental insults. 2,3 The most common cause of DCM is ischemic heart disease and among the non-ischemic etiologies, idiopathic DCM is the most prevalent form. The other identifiable causes include those induced by genetic or syndromic disorders, toxins, chronic alcoholism, infections, nutritional deficiencies, endocrine or autoimmune disorders and rarely pregnancy.…”

“…The other identifiable causes include those induced by genetic or syndromic disorders, toxins, chronic alcoholism, infections, nutritional deficiencies, endocrine or autoimmune disorders and rarely pregnancy. 3,4…”