The Prognostic Impact of the Evolution of RV Function in Idiopathic DCM

Merlo, Marco; Gobbo, Marco; Stolfo, Davide; Losurdo, Pasquale; Ramani, Federica; Barbati, Giulia; Pivetta, Alberto; Lenarda, Andrea Di; Anzini, Marco; Gigli, Marta; Pinamonti, Bruno; Sinagra, Gianfranco

doi:10.1016/j.jcmg.2016.01.027

Cited by 95 publications

(93 citation statements)

References 26 publications

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“…The recovery of right ventricular function under therapy is frequent and can be observed already at 6 months. It precedes LVRR, and is emerging as an early therapeutic target and an independent prognostic predictor . Improvement in right ventricular function is also described in CRT recipients as a secondary expression of haemodynamic improvement very early after resynchronization, with consequently favourable survival rates .…”

Section: The Cornerstones Of Clinical Management Of Dilated Cardiomyomentioning

confidence: 99%

“…Improvement in right ventricular function is also described in CRT recipients as a secondary expression of haemodynamic improvement very early after resynchronization, with consequently favourable survival rates . In contrast, the development of right ventricular dysfunction during long‐term follow‐up is an expression of structural disease progression and portends a negative outcome Functional mitral regurgitation conveys important prognostic implications.…”

Section: The Cornerstones Of Clinical Management Of Dilated Cardiomyomentioning

confidence: 99%

“…It precedes LVRR, and is emerging as an early therapeutic target and an independent prognostic predictor. 28 Improvement in right ventricular function is also described in CRT recipients as a secondary expression of haemodynamic improvement very early after resynchronization, with consequently favourable survival rates. 29 In contrast, the development of right ventricular dysfunction during long-term follow-up is an expression of structural disease progression and portends a negative outcome.…”

Section: Other Markers Of Disease Severity and Progressionmentioning

confidence: 99%

“…29 In contrast, the development of right ventricular dysfunction during long-term follow-up is an expression of structural disease progression and portends a negative outcome. 28 • Functional mitral regurgitation conveys important prognostic implications. Moderate to severe mitral regurgitation at diagnosis or persistent mitral regurgitation despite optimal medical treatment or CRT is associated with poorer outcomes.…”

Section: Other Markers Of Disease Severity and Progressionmentioning

confidence: 99%

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Evolving concepts in dilated cardiomyopathy

Merlo

Cannatà

Gobbo

et al. 2017

European J of Heart Fail

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278

270

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Dilated cardiomyopathy (DCM) represents a particular aetiology of systolic heart failure that frequently has a genetic background and usually affects young patients with few co-morbidities. The prognosis of DCM has improved substantially during the last decades due to more accurate aetiological characterization, the red-flag integrated approach to the disease, early diagnosis through systematic familial screening, and the concept of DCM as a dynamic disease requiring constant optimization of medical and non-pharmacological evidence-based treatments. However, some important issues in clinical management remain unresolved, including the role of cardiac magnetic resonance for diagnosis and risk categorization and the interaction between genotype and clinical phenotype, and arrhythmic risk stratification. This review offers a comprehensive survey of these and other emerging issues in the clinical management of DCM, providing where possible practical recommendations.

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Section: The Cornerstones Of Clinical Management Of Dilated Cardiomyomentioning

confidence: 99%

Section: The Cornerstones Of Clinical Management Of Dilated Cardiomyomentioning

confidence: 99%

Section: Other Markers Of Disease Severity and Progressionmentioning

confidence: 99%

Section: Other Markers Of Disease Severity and Progressionmentioning

confidence: 99%

See 2 more Smart Citations

Evolving concepts in dilated cardiomyopathy

Merlo

Cannatà

Gobbo

et al. 2017

European J of Heart Fail

Self Cite

278

270

View full text Add to dashboard Cite

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“…In patients whose RV function improved, there was found to be subsequent LV remodeling. Right ventricular dysfunction was also associated with heart transplantation and death . As a result, it appeared that evaluation of the RV function over time provided long‐term prognostic data.…”

Section: Current Evaluation Of the Rv In Selected Diseasesmentioning

confidence: 99%

Echocardiographic evaluation of the right ventricle: Clinical implications

Dutta

Aronow

2017

Clinical Cardiology

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Interest in evaluation of the right ventricle (RV) has increased recently. With the growth of new echocardiographic techniques and technology, there has been a corresponding increase in the ability to evaluate the RV, both qualitatively and quantitatively. Older echocardiographic techniques, such as right ventricular fractional area of change, tricuspid annular plane systolic excursion, and tissue S 0 , and newer echocardiographic techniques including 3-dimensional evaluation and global longitudinal strain, can improve our evaluation of RV function. These techniques provide both diagnostic and prognostic data on a large variety of clinical diseases including pulmonary hypertension and congestive heart failure. With the continuing and exponential advances in technology, echocardiography is well poised to become the primary modality to evaluate the RV. | ANATOMY OF THE RVThe RV is composed of 3 different segments: the inlet area, the trabecular portion, and the outflow area. The inlet extends from the papillary muscles to the tricuspid annulus. The trabecular portion extends from the papillary muscles to the right ventricular (RV) apex.The outflow portion is a smooth area leading to the pulmonic valve. 1Because the RV does not follow a traditional symmetrical shape, the RV volume does not lend itself to estimation. Wall-motion abnormalities are also more difficult to evaluate, as there are 3 different subsections. Wall motion is also difficult to evaluate due to a combination of radial, longitudinal, and circumferential shortening; these independent movements are not clearly visible on an echocardiogram. 2Normal values for the RV were significantly limited due to the lack of standardization across echocardiographic protocols. cMRI, which measures the RV in planes that are not visualized on echocardiography, was able to provide a series of normal valves. As a result, we know that although RV mass and volumes are larger among males vs females, there is no significant difference in systolic function. | FUNCTION OF THE RVThe LV is often described as a pump whose function is based on its inherent contractility. In contrast, the RV is profoundly affected by loading conditions. The RV function is dependent on preload and afterload.2 It provides the same stroke volume as the LV with

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