Abstract
Dilated cardiomyopathy (DCM) is the most common form of cardiomyopathy and one of the most common causes of heart failure. It is characterized by left or biventricular dilation and a reduced systolic function. The causes are manifold and range from myocarditis to alcohol and other toxins, to rheumatological, endocrinological, and metabolic diseases. Peripartum cardiomyopathy is a special form that occurs at the end of or shortly after pregnancy. Genetic mutations can be detected in approximately 30–50% of DCM patients. Owing to the growing possibilities of genetic diagnostics, increasingly more triggering variants and hereditary mechanisms emerge. This is particularly important with regard to risk stratification for patients with variants with an increased risk of arrhythmias. Patient prognosis is determined by the occurrence of heart failure and arrhythmias. In addition to the treatment of the underlying disease or the elimination of triggering harmful toxins, therapy consists in guideline-directed heart failure treatment including drug and device therapy.
Highlights
Dilated cardiomyopathy (DCM) is often the final stage of various underlying diseases, whereby the diagnosis thereof offers specific therapeutic options
Cardiac autoantibodies to various cardiac and muscle-specific autoantigens are found in myocarditis and in DCM patients but the role of autoantibodies in the progression from myocarditis to DCM is still not fully understood [19]
The detailed work-up of the patient’s history including a comprehensive medical history of the family is decisive to estimate the probability of a genetic origin of the cardiomyopathy [35]
Summary
Cardiomyopathies represent an inhomogeneous group of cardiac diseases with structural and functional changes in the myocardium that can cause heart failure and death [1, 2]. In 1980, the World Health Organization(WHO)defined cardiomyopathies as myocardial diseases of unknown cause to distinguish cardiomyopathies from myocardial diseases secondary to hypertension, coronary heart disease, or valvular disease [2]. In 1996, this classification was extended to all diseases of the heart muscle—the WHO defined cardiomyopathies as myocardial diseases associated with cardiac dysfunction [3]. The current definition of the European Society of Cardiology (ESC) defines cardiomyopathies as myocardial dysfunction in which the myocardium is structurally and functionally altered in the absence of coronary heart disease, hypertension, valvular disease, or congenital heart disease [4]. Patients with dilated cardiomyopathy (DCM) can develop reduced ejection fraction and, as the disease progresses, an increased risk of arrhythmias and sudden cardiac death [1]
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