Maintaining Success for Patients With Dilated Cardiomyopathy and Remission of Heart Failure

Remission of heart failure, defined by resolution of symptoms, normalization of left ventricular ejection fraction, and plasma concentrations of natriuretic peptides and by the ability to withdraw diuretic agents without recurrence of congestion is increasingly recognized among patients with dilated cardiomyopathy. Once remission has been achieved, it is unclear which treatments need to be continued long term. The durability of remission and likelihood of relapse are likely to be determined by intrinsic myocardial susceptibility, the persistence or recurrence of any acquired triggers, and current and future myocardial workload. Each of these should be addressed to enable personalized therapy to delay or prevent relapse. Management should be informed by evidence from randomized trials of targeted therapeutic strategies. (J Am Coll Cardiol Basic Trans Science 2022;7:500???503) ?? 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Automated summary

Remission of heart failure refers to a state where symptoms disappear, cardiac function returns to normal, and natriuretic peptide levels normalize. The continuation of treatments necessary for sustained remission remains unclear, and factors such as myocardial susceptibility, persistence or recurrence of triggers, and myocardial workload should be considered. Personalized therapy informed by evidence from randomized trials of targeted therapeutic strategies is recommended.