Skip to main content
SpringerLink
Log in

Prognosis and Management

  • Chapter
Cardiomyopathies

Abstract

Dilated cardiomyopathy is a disease of unknown etiology that principally affects the myocardium [1]. The diagnosis of dilated cardiomyopathy is established by the presence of left ventricular dilatation and systolic dysfunction in the absence of congenital, coronary, valvular, or pericardial heart disease [2]. In some patients the development of dilated cardiomyopathy is associated with clinical factors such as alcoholism, pregnancy or a family history of cardiomyopathy [1,2]. However, dilated cardiomyopathy is distinct from specific heart muscle disease (“secondary myocardial disease”), which occurs with a specific systemic disorder that may be metabolic, collagen-vascular, infiltrative, neuromuscular, inflammatory, or neoplastic in origin [1, 2] (see Chap. 1). There are currently no specific gross anatomic, histologic, or ultrastructural morphologic features which can differentiate dilated cardiomyopathy from other causes of heart failure [3]. Since dilated cardiomyopathy is defined clinically, it is likely that several specific etiologies are responsible for this condition. It is therefore not surprising that patients with dilated cardiomyopathy have a heterogeneous clinical presentation and prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Shabetai R (1983) Cardiomyopathy: how far have we come in 25 years, how far yet to go? J Am Coll Cardiol 1: 252–263

    Article  PubMed  CAS  Google Scholar 

  2. Johnson RA, Palacios I (1982) Dilated cardiomyopathies of the adult. N Engl J Med 307: 1051–1058

    Article  PubMed  CAS  Google Scholar 

  3. Silver MA (1988) Anatomy of the failing heart in dilated cardiomyopathy. In: Engelmeier RS, O’Connell JB (eds) Drug therapy in dilated cardiomyopathy and myocarditis. Dekker,New York, pp 1–12

    Google Scholar 

  4. McKee PA, Castelli UP, McNamara PM et al. (1971). The natural history of congestive heart failure: the Framingham study. N Engl J Med 285: 1441–1446

    Article  PubMed  CAS  Google Scholar 

  5. Torp A (1978) Incidence of congestive cardiomyopathy. Postgrad Med J 54: 435–437

    Article  PubMed  CAS  Google Scholar 

  6. Gavazzi A, Lanzarini L, Cornalba C, Desperati M, Raisaro A, Angoli L, de Servi S, Specchia G (1984) Dilated (congestive) cardiomyopathy. G ltal Cardiol 14: 492–498

    CAS  Google Scholar 

  7. Gorlin R (1983) Incidence, etiology and prognosis of heart failure. Cardiovasc Rev Rep 4: 765

    Google Scholar 

  8. Fuster V, Gersh BJ, Giuliana ER, Tajik AJ, Brandenburg RO, Frye RL, (1981) The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 47: 525

    Article  PubMed  CAS  Google Scholar 

  9. Hofmann T, Meinertz T, Kasper W, Geibel A, Zehender M, Hohnloser S, Stienen U, Treese N, Just H (1988) Modle of death in idiopathic dilated cardiomyopathy: a multivariate analysis of prognostic determinants. Am Heart J 116: 1455

    Article  PubMed  CAS  Google Scholar 

  10. Diaz RA, Obasohan A, Oakley CM et al. (1987) Prediction of outcome in dilated cardiomyopathy. Br Heart J 58: 393–399

    Article  PubMed  CAS  Google Scholar 

  11. O’Connell JB, Costanzo-Nordin MR, Engelmeier RS, Wallis DE, Robinson JA, Scanlon PJ (1985) Prognosis and treatment of cardiomyopathy and myocarditis. Heart Vessels 1 Suppl I: 175–179

    Google Scholar 

  12. Unverferth DV, Magorien RD, Mosechberger ML, Baker PB, Fetters JK, Leier CV (1984) Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 54: 147–152

    Article  PubMed  CAS  Google Scholar 

  13. Franciosa JA,Wilen M, Ziesche S, Cohn JN (1983) Survival in men with severe chronic left ventricular failure due to either coronary heart disease or idiopathic dilated cardiomyopathy. Am J Cardiol 51: 831–836

    Article  Google Scholar 

  14. Figulla HR, Rahlf G, Nieger M, Luig H, Kreuzer H (1985). Spontaneous hemodynamic improvement or stabilization and associated biopsy findings in patients with congestive cardiomyopathy. Circulation 71: 1095–1104

    Article  PubMed  CAS  Google Scholar 

  15. Convert G, Delaye J, Beaune J, Biron A, Gonin A (1980). Etude pronostique des myocardiopathies primitive non obstructives. Arch Mal Coeur 27: 22T - 237

    Google Scholar 

  16. Lengyel M, Kokeny M (1981) Follow-up study in congestive (dilated) cardiomyopathy. Acta Cardiol 1: 35–48

    Google Scholar 

  17. Meinertz T, Hofmann T, Kasper W, Treese N, Bechtold H, Stienen U, Pop T, Leitner E-RV, Andresen D, Meyer J (1984) Significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 53: 902–907

    Article  PubMed  CAS  Google Scholar 

  18. Romeo F, Pelliccia F, Cianfrocca C, Cristofani R, Reale A (1989) Predictors of sudden death in idiopathic dilated cardiomyopathy. Am J Cardiol 63: 138–140

    Article  PubMed  CAS  Google Scholar 

  19. Koide T, Kato A, Takabatake Y, Iizuka M, Uchida Y, Ozeki K, Morooka S, Kakihana M, Serizawa T, Tanaka S, Ohya T, Momomura S, Murao S (1980) Variable prognosis in congestive cardiomyopathy: role of left ventricular function, alcoholism, and pulmonary thrombosis. Jpn Heart J 21: 451–463

    Article  PubMed  CAS  Google Scholar 

  20. Stevenson LW, Fowler MB, Schroeder JS, Stevenson WG, Dracup KA, Fond V (1987) Poor survival of patients with idiopathic cardiomyopathy considered too well for transplantation. Am J Med 83: 871–876

    Article  PubMed  CAS  Google Scholar 

  21. Keogh AM, Freund J, Baron DW, Hickie JB (1988) Timing of cardiac transplantation in idiopathic dilated cardiomyopathy. Am J Cardiol 61: 418–422

    Article  PubMed  CAS  Google Scholar 

  22. Kuhn H, Becker R, Fischer J, Curtius JM, Losse B, Hort W, Loogen F (1982)Untersuchungen zur Atiologie, zum Verlauf and zur Prognose der dilatativen Kardiomyopathie (DCM). Z Kardiol 71: 497–508

    Google Scholar 

  23. Strain JE, Grose RM, Cho S, Factor SM (1985) Short term natural history of untreated myocarditis (Abstr). Circulation 72-III: 110

    Google Scholar 

  24. Quigley PJ, Richardson PJ, Meany BT, Olsen EGJ,Monaghan M, Jackson G, Jewitt DE (1987) Long term follow up in biopsy proven myocarditis: progression to dilated cardiomyopathy. Br Heart J 57: 71

    Google Scholar 

  25. Demakis JG, Rahimtoola SH, Sutton GC, Meadows WR, Szanto PB, Tobin JR, Gunnar RM (1971) Natural course of peripartum cardiomyopathy. Circulation 44: 1053–1061

    PubMed  CAS  Google Scholar 

  26. DeMakis JG, Proskey A, Rahimtoola SH, Jamil M, Sutton GC, Rosen KM, Gunnar RM, Tobin JR (1974) The natural course of alcoholic cardiomyopathy. Ann Intern Med 80: 293–297

    PubMed  CAS  Google Scholar 

  27. Schwartz L, Sample KA, Wigle ED (1975) Severe alcoholic cardiomyopathy reversed with abstention from alcohol. Am J Cardiol 36: 963–966

    Article  PubMed  CAS  Google Scholar 

  28. Costanzo-Nordin MR, O’Connell JB, Engelmeier RS, Moran JF, Scanlon PJ (1985) Dilated cardiomyopathy: functional status, hemodynamics, arrhythmias, and prognosis. Cathet Cardiovasc Diagn 11: 445–453

    Article  PubMed  CAS  Google Scholar 

  29. Olshausen AV, Stienen U, Schwarz F, Kubler W, Meyer J (1988) Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy. Am J Cardiol 61: 146–151

    Article  PubMed  CAS  Google Scholar 

  30. Holmes J, Kubo SH, Cody RJ, Kligfield P (1985) Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography. Am J Cardiol 55: 146–151

    Article  PubMed  CAS  Google Scholar 

  31. Das SK, Mordy F, DiCarlo L, Baerman J, Krol R, de Buitleir M, Crevey B (1986) Prognostic usefulness of programmed ventricular stimulation in idiopathic dilated cardiomyopathy without symptomatic ventricular arrhythmias. Am J Cardiol 58: 998–1000

    CAS  Google Scholar 

  32. Poll DS, Marchlinski FE, Buxton AE, Josephson ME (1986) Usefulness of programmed stimulation in idiopathic dilated cardiomyopathy. Am J Cardiol 58: 992–997

    Article  PubMed  CAS  Google Scholar 

  33. Baandrup U, Florio RA, Rehahn M, Richardson PJ, Olsen EGJ (1981) Critical analysis of endomyocardial biopsies from patients suspected of having cardiomyopathy. Br Heart J 45: 487–493

    Article  PubMed  CAS  Google Scholar 

  34. Hammond EH, Menlove RL, Anderson JL (1987) Predictive value of immunofluorescence and electron microscopic evaluation of endomyocardial biopsies in the diagnosis and prognosis of myocarditis and idiopathic dilated cardiomyopathy. Am Heart J 114: 1055

    Article  PubMed  CAS  Google Scholar 

  35. Levine TB, Francis GS, Goldsmith SR, Simon AB, Cohn JN (1982) Activity of the sympathetic nervous system and renin—angiotensin system assessed by plasma hormone levels and their relation to hemodynamic abnormalities in congestive heart failure. Am J Cardiol 49: 1659

    Article  PubMed  CAS  Google Scholar 

  36. Francis GS, Benedict C, Johnstone DE, Kirlin PC, Nicklas J, Liang C-S, Kubo SH, RudinToretsky E, Yusuf S (1990) Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. Circulation 82: 1724–1729

    Article  PubMed  CAS  Google Scholar 

  37. Maisel AS, Scott NA, Motulsky Hi, Michel MC, Boublik JH, Rivier JE, Ziegler M, Allen RS, Brown MR (1989) Elevation of plasma neuropeptide Y levels in congestive heart failure. Am J Med 86: 43

    Article  PubMed  CAS  Google Scholar 

  38. Cohn JN, Levine TB, Olivari MT, Garberg V, Lura D, Francis GS, Simon AB, Rector T (1984) Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure. N Engl J Med 311: 819–823

    Article  PubMed  CAS  Google Scholar 

  39. Swedberg K, Eneroth P, Kjekshus J, Wilhelmsen L (1990) Hormones regulating cardiovascular function in patients with severe congestive heart failure and their relation to mortality. Circulation 82: 1730–1736

    Article  PubMed  CAS  Google Scholar 

  40. Lee WH, Packer M (1986) Prognostic importance of serum sodium concentration and its modification by converting-enzyme inhibition in patients with severe chronic heart failure. Circulation 73: 257–267

    Article  PubMed  CAS  Google Scholar 

  41. Mason JW, Billinggham ME, Ricci DR (1980) Treatment of acute inflammatory myocarditis assisted by endomyocardial biopsy. Am J Cardiol 45: 1037–1044

    Article  PubMed  CAS  Google Scholar 

  42. Gilbert EM, Mason JW Immunosuppressive therapy of myocarditis. In: Engelmeier RS, O’Connell JB (eds) Drug therapy in dilated cardiomyopathy and myocarditis. Dekker, New York, pp 233–263

    Google Scholar 

  43. Doherty JE (1988) Use of digitalis and diuretics in the treatment of heart failure. In: Cohn JN (ed) Drug treatment of heart failure. Advanced Therapeutics Communications International, Secaucus, pp 147–178

    Google Scholar 

  44. Renlin FC The actions and use of diuretics in renal disease. In: Freidkey CK (ed) Heart, kidney and electrolytes. Grune and Stratton, New York, pp 169–193

    Google Scholar 

  45. Craswell PW, Ezzati E, Kopstein J et al. (1973) Use of metolazone, a new diuretic, in patients with renal disease. Nephron 12: 63–73

    Article  Google Scholar 

  46. CONSENSUS Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 316: 1429–1435

    Article  Google Scholar 

  47. Cohn JN, Archibald DG, Ziesche S, Franciosa JA, Harston WE, Tristani FE, Dunkman WB, Jacobs W, Francis GS, Flohr KH, Goldman S, Cobb FR, Shah PM, Saunders R, Fletcher RD, Loeb HS, Hughes VC, Baker B (1986) Effect of vasodilator therapy on mortality in chronic congestive heart failure. N. Engl J Med 314: 1547–1552

    Article  PubMed  CAS  Google Scholar 

  48. Cody RJ, Franklin KW, Kluger J, Laugh LH (1982) Sympathetic responsiveness and plasma norepinephrine during therapy of chronic congestive heart failure with captopril. Am J Med 72: 791–797

    Article  PubMed  CAS  Google Scholar 

  49. Cleland JGF, Dangic H, Horsman GP et al. (1984) Captopril in heart failure, a double blind controlled trial. Br Heart J 52: 530–535

    Article  PubMed  CAS  Google Scholar 

  50. Captopril-Digoxin Multicenter Research Group (1988) Comparative effects of therapy with captopril and digoxin in patients with mild to moderate heart failure. JAMA 259: 539–554

    Article  Google Scholar 

  51. DiBianco R, Shabetai R, Kostuk W et al. (1989) A comparison of oral milrinone, digoxin and their combination in the treatment of patients with chronic heart failure. N Engl J Med 320: 677–683

    Article  PubMed  CAS  Google Scholar 

  52. DiBianco R, Shabetai R, Kostuk W et al. (1989) A comparison of oral milrinone, digoxin and their combination in the treatment of patients with chronic heart failure. N Engl J Med 320: 677–683

    Article  PubMed  CAS  Google Scholar 

  53. Waagstein F, Hjalmmarson A, Varnauskas E, Wallentin I (1975) Effect of chronic beta-adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 37: 1022–1036

    Article  PubMed  CAS  Google Scholar 

  54. Engelmeier RS, O’Connell JB, Walsh R, Rad N, Scanlon PJ, Gunnar RM (1985) Improvement in symptoms and exercise tolerance by metoprolol in patients with dilated cardiomyopathy: a double blind, randomized, placebo-controlled trial. Circulation 72: 526–546

    Article  Google Scholar 

  55. Gilbert EM, Anderson JL, Deitchman D, Yanowitz FG, O’Connell JB, Renlund DG, Bartholomew M, Mealey PC, Larrabee P, Bristow MR (1990) Long-term beta-blocker vasodilator therapy improves cardiac function in idiopathic dilated cardiomyopathy: a double-blind, randomized study of bucindolol versus placebo. Am J Med 88: 223–229

    Article  PubMed  CAS  Google Scholar 

  56. Gilbert EM, Mestroni L, Anderson JL, Woodley SL, Bristow MR (1989) Can response to beta-blocker therapy in idiopathic dilated cardiomyopathy be predicted by baseline parameters? Circulation 80: 11–428

    Google Scholar 

  57. Swedberg K, Waagstein F, Hjalmarson S, Wallentin I (1979) Prolongation of survival in congestive cardiomyopathy by a beta receptor blockade. Lancet I: 1374–1376

    Google Scholar 

  58. Anderson JL, Lutz JR, Gilbert EM, Sorenson SG, Yanowitz FG, Menlove RL, Batholomew M (1985) A randomized trial of low dose beta-blockade therapy for idiopathic dilated cardiomyopathy. Am J Cardiol 55: 471–475

    Article  PubMed  CAS  Google Scholar 

  59. O’Connell JB, Renlund DG, Bristow MR (1989) Cardiac transplantation: emerging role of the internist/cardiologist. J Intern Med 225: 147–156

    Article  PubMed  Google Scholar 

Download references

Authors
  1. E. M. Gilbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Di Lenarda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. B. O’Connell
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Cardiology, Royal Postgraduate Medical School, Du Cane Road, W12 0NN, London, UK

    J. F. Goodwin

  2. Department of Histopathology, Royal Brompton National Heart and Lung Hospital London, Fulham Road, SW3 6HP, London, UK

    E. G. J. Olsen (Consultant Histopathology (Cardiovascular Division) (Consultant Histopathology (Cardiovascular Division)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Gilbert, E.M., Di Lenarda, A., O’Connell, J.B. (1993). Prognosis and Management. In: Goodwin, J.F., Olsen, E.G.J. (eds) Cardiomyopathies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77598-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-77598-7_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-77600-7

  • Online ISBN: 978-3-642-77598-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation