Endomyocardial biopsy and ultrastructural changes in dilated cardiomyopathy: taking a ‘deeper’ look into patients' prognosis
Key result
Ultrastructural myofilament changes on electron microscopy predicted mortality and worsening heart failure in dilated cardiomyopathy, whereas patients without changes had only 3 deaths over 4.9 years.
Why the study?
Do ultrastructural cardiomyocyte changes identified by electron microscopy predict mortality and worsening heart failure in patients with newly diagnosed dilated cardiomyopathy?
Population
250 patients with first diagnosis of dilated cardiomyopathy, presenting with acute heart failure, with…
Comparison
Electron microscopy analysis of endomyocardial… vs No changes in myofilaments on electron microscopy
Design
Editorial
Follow-up
mean 4.9 years
Authors
Discussion
Loading...
Member takes
Implication
Electron microscopy of endomyocardial biopsies can identify ultrastructural myofilament changes that serve as independent predictors of mortality and worsening heart failure in patients with newly diagnosed dilated cardiomyopathy.
Structured PICO
Do ultrastructural cardiomyocyte changes identified by electron microscopy predict mortality and worsening heart failure in patients with newly diagnosed dilated cardiomyopathy?
P
Population
250 patients with a first diagnosis of dilated cardiomyopathy presenting with acute heart failure, followed for a mean of 4.9 years.
E
Exposure
Electron microscopy (EM) analysis of endomyocardial biopsies identifying myofilament changes (focal derangement or diffuse myocyte lysis)
C
Comparator
No changes in myofilaments on electron microscopy
O
Outcome
All-cause death, cardiac death, and worsening heart failure (composite HF endpoint of readmission due to HF or HF death)hard clinical
Electron microscopy of endomyocardial biopsies can identify ultrastructural myofilament changes that serve as independent predictors of mortality and worsening heart failure in patients with newly diagnosed dilated cardiomyopathy.
Limitations
- DCM can be asymptomatic for a long time, making the detection of the exact time point when cardiac changes occur difficult.
- Unclear whether there is an interaction between these changes and genetic causes of DCM or if they are due to different causes.
- DCM can be asymptomatic for a long time, making the detection of the exact time point when cardiac changes occur difficult
- Non-cardiac causes of death accounted for 58% of all observed deaths, implying patients with myofilament changes tended to die more often from non-cardiac causes
Cite This Study
Savvatis et al. (2014) conducted an editorial in Dilated cardiomyopathy (n=250). Ultrastructural cardiomyocyte changes on electron microscopy vs. No ultrastructural changes was evaluated on All-cause death, cardiac death, and worsening heart failure. Ultrastructural myofilament changes on electron microscopy predicted mortality and worsening heart failure in dilated cardiomyopathy, whereas patients without changes had only 3 deaths over 4.9 years.