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Journal of the American College of... Sep 2022
Topics: Cardiomyopathy, Dilated; Genetic Testing; Humans
PubMed: 36109107
DOI: 10.1016/j.jacc.2022.07.010 -
International Heart Journal 2022Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy, and it often has a poor outcome. Sex differences in the prognosis of patients with DCM remain... (Meta-Analysis)
Meta-Analysis
Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy, and it often has a poor outcome. Sex differences in the prognosis of patients with DCM remain controversial. The present meta-analysis aimed to investigate whether sex plays a role in the outcome of patients with DCM and to provide real-world information on these potential sex differences for physicians and patients.We searched the PubMed, Cochrane, and EMBASE databases for published cohort studies up to February 16, 2020 that reported sex-specific prognostic outcomes (e.g., all-cause mortality; sudden cardiac death (SCD) ) in patients with DCM.Finally, 5 clinical cohort studies with a total of 5,709 patients were included. The results showed that males with DCM had a higher risk of all-cause mortality than females (HR: 1.61, 95% CI: 1.36~1.90; P < 0.00001). Next, the included studies were divided into short-term (< 5 years) and long-term (≥ 5 years) outcome groups by follow-up duration. Males showed a higher risk of all-cause mortality in both subgroups (< 5 years, HR: 1.59, 95% CI: 1.13~2.23; P = 0.008; ≥ 5 years, HR: 1.65, 95% CI: 1.33~2.05; P < 0.00001). In addition, the risks of SCD (HR: 1.80, 95% CI: 1.63~2.61; P = 0.002) and cardiovascular mortality in males (HR: 1.67, 95% CI: 1.25~2.23; P = 0.0005) were higher than those in females.The evidence from the published studies suggested that compared with females, males with DCM had an increased risk of all-cause mortality, cardiovascular mortality, and SCD.
Topics: Cardiomyopathy, Dilated; Death, Sudden, Cardiac; Female; Humans; Male; Prognosis; Sex Factors
PubMed: 35095074
DOI: 10.1536/ihj.20-448 -
Current Problems in Cardiology Jan 2013Heart failure due to nonischemic dilated cardiomyopathy (DCM) contributes significantly to the global burden of cardiovascular disease. Myocarditis is, in turn, a major... (Review)
Review
Heart failure due to nonischemic dilated cardiomyopathy (DCM) contributes significantly to the global burden of cardiovascular disease. Myocarditis is, in turn, a major cause of acute DCM in both men and women. However, recent clinical and experimental evidence suggests that the pathogenesis and prognosis of DCM differ between the sexes. This seminar provides a contemporary perspective on the immune mediators of myocarditis, including interdependent elements of the innate and adaptive immune response. The heart's acute response to injury is influenced by sex hormones that appear to determine the subsequent risk of chronic DCM. Preliminary data suggest additional genetic variations may account for some of the differences in epidemiology, left ventricular recovery, and survival between men and women. We highlight the gaps in our knowledge regarding the management of women with acute DCM and discuss emerging therapies, including bromocriptine for the treatment of peripartum cardiomyopathy.
Topics: Animals; Cardiomyopathy, Dilated; Female; Genetic Predisposition to Disease; Gonadal Steroid Hormones; Health Status Disparities; Healthcare Disparities; Humans; Inflammation Mediators; Male; Myocarditis; Myocardium; Recovery of Function; Risk Factors; Sex Factors; Treatment Outcome; Ventricular Function, Left
PubMed: 23158412
DOI: 10.1016/j.cpcardiol.2012.07.003 -
Clinical Cardiology Jan 1995Dilated cardiomyopathy (DCM) is a common and important cause of morbidity and mortality. Many factors can contribute to the development of this disorder, although most... (Review)
Review
Dilated cardiomyopathy (DCM) is a common and important cause of morbidity and mortality. Many factors can contribute to the development of this disorder, although most commonly the etiology is unexplained. However, recent studies in individuals with idiopathic DCM now reveal a heritable cause in 20-30% of individuals. Diverse modes of inheritance have been demonstrated, encompassing an autosomal dominant type (by far the most common), together with recessive and X-linked forms, and maternal inheritance through mitochondrial DNA. The hereditary forms of DCM (HDCM) predominantly affect the left ventricle, although inherited abnormalities affecting primarily the right ventricle also are described. HDCM may occur as a primary cardiomyopathy, or secondary to inherited systemic metabolic or neuromuscular disorders. The causative genes for primary HDCM of the autosomal dominant and recessive types have not yet been discovered, but the combination of family pedigree analysis and phenotyping by echocardiography, together with new genetic techniques, should now allow their identification. Knowledge of the gene or genes responsible for HDCM would improve diagnostic accuracy, facilitate genetic counseling, advance understanding of pathogenesis, and provide the starting point for new methods of treatment. Because of the frequently heritable nature of DCM, it is of great importance that a diligent search for all potentially affected family members be undertaken.
Topics: Cardiomyopathy, Dilated; Chromosome Aberrations; Chromosome Disorders; Humans; Mutation; Prevalence
PubMed: 7704989
DOI: 10.1002/clc.4960180105 -
European Journal of Cardiovascular... Apr 2020Dilated cardiomyopathy (DCM) in children is an important cause of severe heart failure and carries a poor prognosis. Adults with heart failure are at increased risk of... (Comparative Study)
Comparative Study
BACKGROUND
Dilated cardiomyopathy (DCM) in children is an important cause of severe heart failure and carries a poor prognosis. Adults with heart failure are at increased risk of anxiety and depression and such symptoms predict adverse clinical outcomes such as mortality. In children with DCM, studies examining these associations are scarce.
AIMS
We studied whether in children with DCM: (1) the level of emotional and behavioral problems was increased as compared to normative data, and (2) depressive and anxiety problems were associated with the combined risk of death or cardiac transplantation.
METHODS
To assess emotional and behavioral problems in children with DCM, parents of 68 children, aged 1.5-18 years (6.9±5.7 years), completed the Child Behavior Checklist.
RESULTS
Compared to normative data, more young children (1.5-5 years) with DCM had somatic complaints (24.3% vs. 8.0%; p < .001), but fewer had externalizing problems (5.4% vs. 17.0%; p = .049). Overall internalizing problems did not reach significance. Compared to normative data, more older children (6-18 years) showed internalizing problems (38.7% vs. 17.0%; p = .001), including depressive (29.0% vs. 8.0%; p < .001) and anxiety problems (19.4% vs. 8.0%; p = .023), and somatic complaints (29.0% vs. 8.0%; p < .001). Anxiety and depressive problems, corrected for heart failure severity, did not predict the risk of death or cardiac transplantation.
CONCLUSION
Children of 6 years and older showed more depressive and anxiety problems than the normative population. Moreover, in both age groups, somatic problems were common. No association with outcome could be demonstrated.
Topics: Adolescent; Anxiety Disorders; Cardiomyopathy, Dilated; Child; Child Behavior; Child, Preschool; Female; Heart Failure; Heart Transplantation; Humans; Infant; Male; Problem Behavior
PubMed: 31552760
DOI: 10.1177/1474515119876148 -
European Journal of Heart Failure Jul 2020The term dilated cardiomyopathy (DCM) defines a heterogeneous group of cardiac disorders, which are characterized by left ventricular or biventricular dilatation and... (Review)
Review
The term dilated cardiomyopathy (DCM) defines a heterogeneous group of cardiac disorders, which are characterized by left ventricular or biventricular dilatation and systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease sufficient to cause global systolic impairment. In approximately one third of cases, DCM is familial with a genetic pathogenesis and various patterns of inheritance. Although the electrocardiogram (ECG) has been considered traditionally non-specific in DCM, the recently acquired knowledge of the genotype-phenotype correlations provides novel opportunities to identify patterns and abnormalities that may point toward specific DCM subtypes. A learned ECG interpretation in combination with an appropriate use of other ECG-based techniques including ambulatory ECG monitoring, exercise tolerance test and imaging modalities, such as echocardiography and cardiovascular magnetic resonance, may allow the early identification of specific genetic or acquired forms of DCM. Furthermore, ECG abnormalities may reflect the severity of the disease and provide a useful tool in risk stratification and management. In the present review, we discuss the current role of the ECG in the diagnosis and management of DCM. We describe various clinical settings where the appropriate use and interpretation of the ECG can provide invaluable clues, contributing to the important role of this basic tool as cardiovascular medicine evolves.
Topics: Cardiomyopathy, Dilated; Echocardiography; Electrocardiography; Heart Failure; Humans; Risk Assessment
PubMed: 32243666
DOI: 10.1002/ejhf.1815 -
Journal of Veterinary Cardiology : the... Apr 2022Cardiomyopathies such as dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy are common in large breed dogs and carry an overall poor prognosis.... (Review)
Review
Cardiomyopathies such as dilated cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy are common in large breed dogs and carry an overall poor prognosis. Research shows that these diseases have strong breed predilections, and selective breeding has historically been recommended to reduce the disease prevalence in affected breeds. Treatment of these diseases is typically palliative and aimed at slowing disease progression and managing clinical signs of heart failure as they develop. The discovery of specific genetic mutations underlying cardiomyopathies, such as the striatin mutation in Boxer arrhythmogenic right ventricular cardiomyopathy and the pyruvate dehydrogenase kinase 4 and titin mutations in Doberman Pinschers, has strengthened our ability to screen and selectively breed individuals in an attempt to produce unaffected offspring. The discovery of these disease-linked mutations has also opened avenues for the development of gene therapies, including gene transfer and genome-editing approaches. This review article discusses the known genetics of cardiomyopathies in dogs, reviews existing gene therapy strategies and the status of their development in canines, and discusses ongoing challenges in the clinical translation of these technologies for treating heart disease. While challenges remain in using these emerging technologies, the exponential growth of the gene therapy field holds great promise for future clinical applications.
Topics: Animals; Arrhythmogenic Right Ventricular Dysplasia; Cardiomyopathies; Cardiomyopathy, Dilated; Dog Diseases; Dogs; Heart Failure; Mutation
PubMed: 34147413
DOI: 10.1016/j.jvc.2021.05.003 -
Cardiovascular Research Jul 2022
Topics: Cardiomyopathy, Dilated; Genetic Testing; Humans; Pedigree
PubMed: 35726845
DOI: 10.1093/cvr/cvac075 -
Scientific Reports May 2022Dilated cardiomyopathy (DCM) is a primary myocardial disease of unclear mechanism and poor prevention. The purpose of this study is to explore the potential molecular...
Dilated cardiomyopathy (DCM) is a primary myocardial disease of unclear mechanism and poor prevention. The purpose of this study is to explore the potential molecular mechanisms and targets of DCM via bioinformatics methods and try to diagnose and prevent disease progression early. We screened 333 genes differentially expressed between DCM and normal heart samples from GSE141910, and further used Weighted correlation network analysis to identify 197 DCM-related genes. By identifying the key modules in the protein-protein interaction network and Least Absolute Shrinkage and Selection Operator regression analysis, seven hub DCM genes (CX3CR1, AGTR2, ADORA3, CXCL10, CXCL11, CXCL9, SAA1) were identified. Calculating the area under the receiver's operating curve revealed that these 7 genes have an excellent ability to diagnose and predict DCM. Based on this, we built a logistic regression model and drew a nomogram. The calibration curve showed that the actual incidence is basically the same as the predicted incidence; while the C-index values of the nomogram and the four external validation data sets are 0.95, 0.90, 0.96, and 0.737, respectively, showing excellent diagnostic and predictive ability; while the decision curve indicated the wide applicability of the nomogram is helpful for clinicians to make accurate decisions.
Topics: Cardiomyopathy, Dilated; Computational Biology; Humans; Nomograms; Protein Interaction Maps; Regression Analysis
PubMed: 35618744
DOI: 10.1038/s41598-022-13135-y -
Frontiers in Bioscience (Landmark... Jan 2009Myocarditis and dilated cardiomyopathy can potentially originate from autoimmune responses. Although genetic predisposition, viral infection, molecular mimicry, and... (Review)
Review
Myocarditis and dilated cardiomyopathy can potentially originate from autoimmune responses. Although genetic predisposition, viral infection, molecular mimicry, and oxidative stress are potential contributing factors to dilated cardiomyopathy, the underlying mechanism (s) has not been fully elucidated. Autoantibodies (AABs) against cardiotropic targets such as ss-adrenergic receptors, mitochondria proteins, myosin, tropomyocin and actin as well as structural proteins such as laminin and desmin may participate in the development of dilated cardiomyopathy. These autoantibodies disrupt cardiac excitation-contraction coupling and activate immune response to initiate tissue injury through complement and circulatory immunocomplexes (CICs). These antibodies are present prior to the onset of dilated cardiomyopathy and may be used to predict the deterioration of cardiac function. Depletion of these cardiac-specific antibodies by extracorporeal immunoabsorption has been considered as a new and effective approach in the treatment of autoimmunity-induced dilated cardiomyopathy. In order to better understand the pathogenesis and therapeutic remedy against this myopathy, the present review will summarize the manifestation and key signaling mechanisms involved in compromised cardiac contractile function during autoimmunity.
Topics: Autoantibodies; Autoimmune Diseases; Calcium; Cardiomyopathy, Dilated; Genetic Heterogeneity; Humans; Myocardium
PubMed: 19273156
DOI: 10.2741/3334