期刊
HEART
卷 108, 期 13, 页码 998-1004出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/heartjnl-2021-319971
关键词
cardiomyopathy; dilated; arrhythmias; cardiac; electrocardiography; defibrillators; implantable
资金
- NIHR Leicester Biomedical Research Centre with Research Fellowships
- British Heart Foundation Programme Grant [RG/17/3/32774]
- Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme [MR/S037306/1]
- MRC [MR/S037306/1] Funding Source: UKRI
Dilated cardiomyopathy is a common and challenging cardiac disease, with current risk stratification mainly relying on left ventricular ejection fraction and New York Heart Association class. However, these markers have limitations, and exploring new imaging, electrophysiological, and genetic risk markers is crucial for improving patient identification and treatment effectiveness in DCM.
Dilated cardiomyopathy (DCM) is a common yet challenging cardiac disease. Great strides have been made in improving DCM prognosis due to heart failure but sudden cardiac death (SCD) due to ventricular arrhythmias remains significant and challenging to predict. High-risk patients can be effectively managed with implantable cardioverter defibrillators (ICDs) but because identification of what is high risk is very limited, many patients unnecessarily experience the morbidity associated with an ICD implant and many others are not identified and have preventable mortality. Current guidelines recommend use of left ventricular ejection fraction and New York Heart Association class as the main markers of risk stratification to identify patients who would be at higher risk of SCD. However, when analysing the data from the trials that these recommendations are based on, the number of patients in whom an ICD delivers appropriate therapy is modest. In order to improve the effectiveness of therapy with an ICD, the patients who are most likely to benefit need to be identified. This review article presents the evidence behind current guideline-directed SCD risk markers and then explores new potential imaging, electrophysiological and genetic risk markers for SCD in DCM.
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