Key result
Dilated cardiomyopathy is a heterogeneous disease with various etiologies including genetic mutations, toxins, and inflammation, requiring individualized diagnostic work-up and guideline-directed heart failure therapy.
This review highlights the diverse etiologies of dilated cardiomyopathy, emphasizing the growing role of genetic diagnostics in risk stratification and the importance of guideline-directed medical and device therapy.
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.
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Hänselmann et al. (2020) conducted a review in Dilated cardiomyopathy and non-compaction cardiomyopathy. Dilated cardiomyopathy is a heterogeneous disease with various etiologies including genetic mutations, toxins, and inflammation, requiring individualized diagnostic work-up and guideline-directed heart failure therapy.
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