Key result
Substrate-based evaluation alongside GDMT enables timely disease-modifying treatment across cardiomyopathies.
Why the study?
Heart failure is the final common pathway of diverse cardiomyopathies, many of which are treatable if identified early, motivating a review of evidence for precision management across cardiomyopathy subtypes.
Substrate-based evaluation incorporating imaging, biomarkers, and genetics should complement guideline-directed medical therapy to enable timely disease-modifying treatment across cardiomyopathy subtypes.
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Early cardiomyopathy identification in HF may enable targeted therapies; extends evidence for etiology-specific management in new diagnoses.
Background and Objectives: Heart failure (HF) is the final common pathway of diverse cardiomyopathies, many of which are treatable if identified early. Materials and Methods: We conducted a narrative review with a structured literature search of MEDLINE/PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from database inception through 8 September 2026. Controlled vocabulary and free-text terms were combined to identify evidence addressing heart failure across dilated, hypertrophic, restrictive/infiltrative, and iron-overload cardiomyopathies. Priority was given to randomised trials, large observational studies, systematic reviews, contemporary guidelines and consensus statements, and landmark primary studies. Reference lists and forward citations of key publications were additionally reviewed. Evidence was critically interpreted according to study design, methodological limitations, effect magnitude and precision, consistency, and clinical applicability, and was synthesised narratively by cardiomyopathy subtype. No quantitative meta-analysis was performed. HF. Conclusions: Substrate-based evaluation (imaging, biomarkers, and genetics) should complement guideline-directed medical therapy to enable timely disease-modifying treatment and improve outcomes.
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Giraldo et al. (2026) conducted a review in Heart failure across dilated, hypertrophic, restrictive/infiltrative, and iron-overload cardiomyopathies. Substrate-based evaluation (imaging, biomarkers, and genetics) and modern therapeutic algorithms was evaluated. Substrate-based evaluation using imaging, biomarkers, and genetics should complement guideline-directed medical therapy to enable timely disease-modifying treatment across cardiomyopathies.
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