Ischemic and non-ischemic dilated cardiomyopathy
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Dilated Cardiomyopathy is a high-incident disease, which diagnosis of and treatments are clinical priority. The aim of our study was to evaluate the diagnostic potential of cardiac magnetic resonance (CMR) imaging; echocardiography and the biochemical parameters that can help us differentiate between the post-ischemic and non-ischemic dilated cardiomyopathy. Materials and methods. The study enrolled 134 patients with dilated cardiomyopathy: 74 with the post-ischemic form and 60 with the non-ischemic one. All patients underwent a coronary imaging test, with echocardiogram, cardiac magnetic resonance and a blood test. Pro-inflammatory cytokines were evaluated using Luminex kit. Data was compared between the two groups. Results. Echocardiography allowed recognition of Left Ventricular Non Compaction in 2 patients. Longitudinal and circumferential strains were significantly different in the two groups (p<0.05). Using CMR imaging a post-myocarditis scar was diagnosed in 2 patients and a post-ischemic scar in 95% of patients with the chronic ischemic disease. The interleukin IL-1, IL-6 and TNF-α levels were higher in the post-ischemic group compared with the non-ischemic one. Conclusions. The use of second level techniques with a high sensitivity and specificity would help distinguish among different sub-forms of dilated cardiomyopathy.
KeywordsDilated cardiomyopathy Cardiac magnetic resonance
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- Maron BJ, Towbin JA, Thiene G, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006; 113: 1807–1816PubMedCrossRefGoogle Scholar
- Novo S, Akashi Y, Arbustini, Assennato P, Azzarelli S, Barbaro G, Fazio G, Fedele F, Giordan M, Mazzarotto P, Modena MG, Novo G, Parodi G, Rapezzi C, Sconci F, Sganzerla P, Tona F, Salerno-Uriarte JA. Takotsubo Cardiomyopathy: a Consensus document. G Ital Cardiol (Rome), 2008; 9: 785–797Google Scholar
- Sliwa K, Hilfiker-Kleiner D, Petrie MC, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail 2010; 12:767PubMedCrossRefGoogle Scholar
- Manolio TA, Baughman KL, Rodeheffer R et al. Prevalence and etiology of idiopathic dilated cardiomyopathy (summary of a National Heart, Lung and Blood Institute Workshop). Am J Cardiol 1992; 69: 1459–1466Google Scholar
- Mancia G, De Backer G, Dominiczak A et al 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007; 28:1462–1536PubMedGoogle Scholar
- Rydén L, Standl E, Bartnik M et al Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007; 28:88–136PubMedCrossRefGoogle Scholar
- WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004 10; 363:157–163Google Scholar
- Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC), Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van’ t Hof A, Widimsky P, Zahger D. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012 Oct; 33(20):2569–2619PubMedCrossRefGoogle Scholar
- La Grutta L, Runza G, Gentile G, Russo E, Lo Re G, Galia M, Bartolotta TV, Alaimo V, Malagò R, Cademartiri F, Cardinale AE, Midiri M. Prognostic outcome of routine clinical noninvasive multidetector-row computed tomography coronary angiography in patients with suspected coronary artery disease: a 2-year follow-up study. Radiol Med. 2011 Jun; 116(4):521–531PubMedCrossRefGoogle Scholar
- Gulati A, Ismail TF, Jabbour A, Ismail NA, Morarji K, Ali A, Raza S, Khwaja J, Brown TD, Liodakis E, Baksi AJ, Shakur R, Guha K, Roughton M, Wage R, Cook SA, Alpendurada F, Assomull RG, Mohiaddin RH, Cowie MR, Pennell DJ, Prasad SK. Clinical utility and prognostic value of left atrial volume assessment by cardiovascular magnetic resonance in non-ischaemic dilated cardiomyopathy. Eur J Heart Fail. 2013 Jun; 15(6):660–670PubMedCrossRefGoogle Scholar
- Shibasaki I, Nishikimi T, Mochizuki Y, Yamada Y, Yoshitatsu M, Inoue Y, Kuwata T, Ogawa H, Tsuchiya G, Ishimitsu T, Fukuda H. Greater expression of inflammatory cytokines, adrenomedullin, and natriuretic peptide receptor-C in epicardial adipose tissue in coronary artery disease. Regul Pept. 2010 Dec 10;165(2–3):210–217PubMedCrossRefGoogle Scholar