Key result
Integrating CMR and genetic testing improves risk stratification and outcomes in DCM.
Why the study?
Despite advances in therapy, DCM mortality remains high, and early atypical arrhythmogenic phenotypes have raised diagnostic, risk stratification, and treatment-response challenges.
A comprehensive diagnostic pathway incorporating cardiac magnetic resonance and genetic testing is critical for evaluating dilated cardiomyopathy and stratifying arrhythmic risk.
May refine arrhythmic risk assessment in DCM; leaves open prospective validation of outcome benefit.
Dilated cardiomyopathy (DCM) represents one of the most common causes of non-ischemic heart failure, characterised by ventricular dilation alongside systolic dysfunction. Despite advances in therapy, DCM mortality rates remain high, and it is one of the leading causes of heart transplantation. It was recently recognised that many patients present minor structural cardiac abnormalities and express different arrhythmogenic phenotypes before overt heart-failure symptoms. This has raised several diagnostic and management challenges, including the differential diagnosis with other phenotypically similar conditions, the identification of patients at increased risk of malignant arrhythmias, and of those who will have a worse response to medical therapy. Recent developments in complementary diagnostic procedures, namely cardiac magnetic resonance and genetic testing, have shed new light on DCM understanding and management. The present review proposes a comprehensive and systematic approach to evaluating DCM, focusing on an improved diagnostic pathway and a structured stratification of arrhythmic risk that incorporates novel imaging modalities and genetic test results, which are critical for guiding clinical decision-making and improving outcomes.
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Ferreira et al. (2023) studied this question. A comprehensive diagnostic and risk stratification approach using novel imaging and genetic tests is critical for improving outcomes in dilated cardiomyopathy.
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