Tuesday, November 28

What is dilated cardiomyopathy? It affects young people and increases the risk of sudden death

What is dilated cardiomyopathy? It affects young people and increases the risk of sudden death

The dilated cardiomyopathy it is the most common cause of heart failure in young people and the leading cause of transplantation worldwide. In addition, patients with this disease are at increased risk of sudden death.

It is a pathology of the heart muscle that causes an increase in the size of the heart’s ventricles, making it difficult for the organ to pump.

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The origin of this pathology is usually genetic. In fact, it is estimated that in up to 40-50% of patients, this disease is due to genetic alterations that can occur in more than 40 different genes.

In addition to this genetic condition, according to Spanish Heart Foundation, some conditions related to an increased risk of developing dilated cardiomyopathy have been identified.

We are talking about viral infections, autoimmune diseases, pregnancy and exposure to toxins (poisons) or certain medications.

Symptoms of dilated cardiomyopathy

Not all patients with dilated cardiomyopathy experience symptoms. In fact, many claim to be perfectly fine.

In addition, the symptoms of this pathology are very similar to those produced by any type of heart failure. Namely:

Patients suffering from this type of disease Cardiac disease drugs are available to help control symptoms and reduce the worsening of the disease. But, as of yet, there is no medicine or medical procedure that will cure dilated cardiomyopathy.

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In some cases, cardiology experts opt for the implantation of pacemakers or automatic defibrillators. And in the most serious cases, the only alternative is transplantation.

If it has a genetic origin, a worse prognosis

According to the largest study carried out to date in patients with non-ischemic dilated cardiomyopathy studied genetically, it has shown for the first time that patients who have this disease and it is of genetic origin have a worse evolution than the rest.

The work has been published in Journal of the American College of Cardiology, coordinated by Pablo García-Pavía, group leader of the CIBER of Cardiovascular Diseases (CIBERCV) and director of the Family Heart Disease Unit of the Puerta de Hierro Hospital in Majadahonda.

The researchers have reached this conclusion after collecting clinical data from 1,005 genotyped patients in 20 Spanish hospitals between 2015 and 2020, of which 372 (37%) of them had a genetic cause and 633 (63%) did not.

The authors analyzed the clinical evolution of the patients with special attention to the development of end-stage heart failure, malignant ventricular arrhythmias, and the recovery capacity of the heart measured by inverse remodeling of the left ventricle.

Individualized medicine

As explained Pablo García-Pavía, “We observed that people with non-ischemic dilated cardiomyopathy with pathogenic or probably pathogenic variants had a worse prognosis than individuals with a negative genotype, and the clinical course and left ventricular remodeling varied according to the underlying affected gene.”

After a mean follow-up of more than 4 years, the main variable (combination of adverse cardiovascular events) had occurred in 118 (31.7%) of the patients with the positive genotype and in 125 (19.8%) of the group negative.

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End-stage heart failure occurred in 60 (16.1%) patients with a positive genotype and in 55 (8.7%) with a negative one. Finally, malignant ventricular arrhythmia was suffered by 73 patients (19.6%) positive and 77 negative (12.2%).

For the CIBERCV researcher, «the results of our work have a significant impact on the incidence of the disease worldwide and because he is a pioneer in showing the different course of the disease as a function of the causal genetic alteration ».

“This work supports treating patients with dilated cardiomyopathy differently according to their genetics and opens the possibility of applying individualized medicine in this field of Cardiology.”


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