Transient versus persistent improved ejection fraction in non‐ischaemic dilated cardiomyopathy

Manca, Paolo; Stolfo, Davide; Merlo, Marco; Gregorio, Caterina; Cannatà, Antonio; Ramani, Federica; Nuzzi, Vincenzo; Lund, Lars H.; Savarese, Gianluigi; Sinagra, Gianfranco

doi:10.1002/ejhf.2512

Cited by 25 publications

(23 citation statements)

References 30 publications

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“…Biomarkers, especially natriuretic peptides, or advanced imaging characterization were not available for all patients. Furthermore, trajectories of echocardiographic parameters, which has been demonstrated prognostically relevant, 40 were not available for all patients. Limiting the study to those with available data might have introduced selection bias.…”

Section: Discussionmentioning

confidence: 99%

Clinical characterization and natural history of chemotherapy‐induced dilated cardiomyopathy

et al. 2022

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Aims Chemotherapy-induced dilated cardiomyopathy (CI-DCM) is a well-recognized phenotype of non-ischemic dilated cardiomyopathy (DCM), characterized by poor outcomes. However, a detailed comparison between idiopathic DCM (iDCM) and CI-DCM is still lacking. Methods and resultsAll consecutive DCM patients enrolled in the Trieste Muscle Heart Disease Registry were analysed. CI-DCM and iDCM were defined according to current recommendations. The primary study outcome measure was all-mortality death and secondary outcomes were a) a composite of cardiovascular death/heart-transplantation/ventricularassist-device implantation, and b) major ventricular arrhythmias. The study included 551 patients (499 iDCM and 52 CI-DCM). At enrolment, compared with iDCM, CI-DCM patients were older (51 ± 14 years vs. 58 ± 3 years, respectively, P < 0.001) and had a higher left ventricular ejection fraction (32% ± 9 vs. 35% ± 10, respectively, P = 0.03). Over a median follow-up of 90 months (IQR 54-140 months), CI-DCM patients had a higher incidence of all-cause mortality compared with iDCM (36.5% vs. 8.4% in CI-DCM and iDCM respectively, P < 0.001), while the incidence of major ventricular arrhythmias was higher in the iDCM group compared with CI-DCM (4% vs. 0%, in CI-DCM and iDCM respectively, P = 0.03). The risk of the composite outcome was comparable between the two groups (P = 0.91). At Cox multivariable analysis, the diagnosis of CI-DCM emerged as independently associated to primary outcome (HR 6.42, 95% C.I. 2.52-16.31, P < 0.001). Conclusions In a well-selected DCM cohort, patients with a chemotherapy-induced aetiology had a higher incidence of all-cause mortality compared with iDCM. Conversely, the incidence of life-threatening ventricular arrhythmic events was higher among patients with iDCM.

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Section: Discussionmentioning

confidence: 99%

Clinical characterization and natural history of chemotherapy‐induced dilated cardiomyopathy

et al. 2022

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“…LVEF and LV size, as well as changes in these variables, independently predict all-cause and cardiovascular mortality 24 25. LV reverse remodelling, characterised by improvement in LVEF and reduction in LV size, occurs in >50% of patients with DCM treated with contemporary guideline directed therapy and is associated with a good outcome 26. Follow-up imaging after the initial diagnosis therefore provides important information on trajectory, response to treatment and future prognosis.…”

Section: Informing Prognosismentioning

confidence: 99%

State of the art: multimodality imaging in dilated cardiomyopathy

Halliday

2022

Heart

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Dilated cardiomyopathy represents a common phenotype expressed in individuals with a family of overlapping myocardial diseases due to acquired and/or genetic susceptibility. Disease trajectory, response to therapy and outcomes vary widely; therefore, further refinement of the diagnosis can help guide therapy and inform prognosis. Multimodality imaging plays a key role in this process, as well as excluding alternative causes which may mimic a primary myocardial disease. The following article discusses the role of different imaging modalities as well as what the future may look like in the context of recent research innovations.

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“…In this issue of the Journal, Manca and colleagues present the findings of a retrospective study describing the outcome of 800 patients with non-ischaemic dilated cardiomyopathy (DCM) enrolled in the Trieste Heart Muscle Disease Registry between 1991 and March 2018. 6 We learn several important messages about the phenotype and outcome of patients with HFimpEF from these impressive data. The Trieste team show that left ventricular reverse remodelling is becoming more common with 57% of patients meeting the definition for HFimpEF during an impressive median follow-up of 11 years.…”

Section: This Article Refers To 'Transient Versus Persistent Improved...mentioning

confidence: 99%

“…In this issue of the Journal, Manca and colleagues present the findings of a retrospective study describing the outcome of 800 patients with non‐ischaemic dilated cardiomyopathy (DCM) enrolled in the Trieste Heart Muscle Disease Registry between 1991 and March 2018 6 . We learn several important messages about the phenotype and outcome of patients with HFimpEF from these impressive data.…”

Section: Figurementioning

confidence: 99%

The spectrum of heart failure with improved ejection fraction: persistent congestion, to heart failure remission and perhaps recovery?

Ragavan

Hogan

Halliday

2022

European J of Heart Fail

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Transient versus persistent improved ejection fraction in non‐ischaemic dilated cardiomyopathy

Cited by 25 publications

References 30 publications

Clinical characterization and natural history of chemotherapy‐induced dilated cardiomyopathy

Clinical characterization and natural history of chemotherapy‐induced dilated cardiomyopathy

State of the art: multimodality imaging in dilated cardiomyopathy

The spectrum of heart failure with improved ejection fraction: persistent congestion, to heart failure remission and perhaps recovery?

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