Emerging Techniques for Risk Stratification in Nonischemic Dilated Cardiomyopathy: JACC Review Topic of the Week

J Am Coll Cardiol. 2020 Mar 17;75(10):1196-1207. doi: 10.1016/j.jacc.2019.12.058.

Abstract

Dilated cardiomyopathy (DCM) is a common condition, which carries significant mortality from sudden cardiac death and pump failure. Left ventricular ejection fraction has conventionally been used as a risk marker for sudden cardiac death, but has performed poorly in trials. There have been significant advances in the areas of cardiac magnetic resonance imaging and genetics, which are able to provide useful rick prediction in DCM. Biomarkers and cardiopulmonary exercise testing are well validated in the prediction of risk in heart failure; however, they have been tested less specifically in the DCM setting. This review will discuss these methods with a view toward multiparametric risk assessment in DCM with the hope of creating parametric risk models to predict sudden cardiac death and pump failure in the DCM population.

Keywords: biomarkers; cardiac magnetic resonance; cardiopulmonary exercise testing; dilated cardiomyopathy; genetics; nonischemic cardiomyopathy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiomyopathy, Dilated / diagnostic imaging*
  • Cardiomyopathy, Dilated / genetics*
  • Cardiomyopathy, Dilated / mortality
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / prevention & control
  • Humans
  • Magnetic Resonance Imaging, Cine / methods*
  • Magnetic Resonance Imaging, Cine / trends
  • Risk Assessment
  • Sequence Analysis, DNA / methods*
  • Sequence Analysis, DNA / trends
  • Stroke Volume / physiology