What is dilated cardiomyopathy?

  • U. Kühl
  • H.-P. Schultheiss
Conference paper


Cardiomyopathies are diseases of the myocardium with cardiac dysfunction not due to specific causes such as hypertension, congenital, valvular, coronary, arterial, or pericardial abnormalities. According to the definition of the WHO, primary cardiomyopathies are classified as dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy (18). Dilated cardiomyopathy is the most common cause of chronic heart failure. The involved pathogenetic mechanisms, the incidence and exact time course of the disease are yet unknown. It may be idiopathic or familial/genetic although specific causes such as a viral and/or (auto)immune involvement of the heart have been recognized as a possible cause of the disease.


Dilate Cardiomyopathy Endomyocardial Biopsy Viral Myocarditis Viral Persistence Acute Myocarditis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Archard LC, Bowles NE, Cunningham L, Freeke CA, Olsen EG, Rose ML, Meany B, Why HJF, Richardson FJ (1991) Molecular probes for detection of persisting enterovirus infection of human heart and their prognostic value. Eur Heart J; 12(Suppl D): 56–59PubMedGoogle Scholar
  2. 2.
    Bowles NE, Ohlsen EGJ, Richardson PJ, Archard LC (1986) Detection of Cocksackie B-virus-specific RNA sequences in myocardial biopsy samples from patients with myocarditis and dilated cardiomyopathy. Lancet; 1:1120–1122PubMedCrossRefGoogle Scholar
  3. 3.
    Billingham MB (1987) Acute myocarditis: a diagnostic dilemma. B3 Heart J; 58:6–8.CrossRefGoogle Scholar
  4. 4.
    Grasso M, Arbusti E, Silini E, Diegoli M, Percivalle E, Ratti G, Bramerio M, Gavazzi A, Vigano M, Milanesi G (1992) Search for Coxsackie B3 RNA in idiopathic dilated cardiomyopathy using gene amplification by polymerase chain reaction. Am J Cardiol; 69:658–664PubMedCrossRefGoogle Scholar
  5. 5.
    Hauck AJ, Kearney DL, Edwards WD (1989) Evaluation of postmortem endomyocardial biopsy specimen from 38 patients with lymphocytic myocarditis: Implication for role of sampling error. Mayo Clin Proc; 64:1235–1245PubMedGoogle Scholar
  6. 6.
    Hosenpud JD, McAnulty JH, Niles NR (1985) Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone. J.Am. Coll. Cardiol. 6, 217–222CrossRefGoogle Scholar
  7. 7.
    Kandolf R, Ameis D, Kirschner P, Canu A, Hofschneider P1H (1985) In situ detection of enteroviral genomes in myocardial cells by nucleic acid hybridization: An approach to the diagnosis of viral heart disease. Proc Natl Acad Sci; 82:4818–4822PubMedCrossRefGoogle Scholar
  8. 8.
    Kühl U, Noutsias M, Seeberg B, Schannwell M, Welp LB Schultheiss H-P (1994) Chronic inflammation in the myocardium of patients with clinically suspected dilated cardiomyopathy. J Card Failure; 1:13–27CrossRefGoogle Scholar
  9. 9.
    Kühl U, Noutsias M, Seeberg B, Schannwell M, Welp LB, Schultheiß H-P Strauer BE Chronic inflammation in the myocardium of patients with clinically suspected dilated cardiomyopathy. J Heart Failure (January 1994), 231–245Google Scholar
  10. 10.
    Kühl U, Schultheiß H-P, Strauer BE (1994) Methylprednisolone in chronic myocarditis. Postgrad. Med. J. 70; S35-S42Google Scholar
  11. 11.
    Kühl U, Seeberg B, Noutsias M, Schultheiß H-P (1995) Immunohistochemical analysis of the chronic inflammatory process in dilated cardiomyopathy: Brit Heart J; 75:295–300CrossRefGoogle Scholar
  12. 12.
    Latham RD, Mulrow JP, Virmani R, Robinowitz M, Moody JM (1989) Recently diagnosed idiopathic dilated cardiomyopathy: incidence of myocarditis and efficacy of prednisone therapy. Am. Heart J. 117, 876–882PubMedCrossRefGoogle Scholar
  13. 13.
    Limas CJ, Goldenberg JF, Limas C (1989) Autoantibodies against β-adrenoceptors in human idiopathic dilated cardiomyopathy. Circ Res; 64:97–103PubMedGoogle Scholar
  14. 14.
    Mason JW, Billingham ME, Ricci DR (1980) Treatment of acute inflammatory myocarditis assisted by endomyocardial biopsy. Am. J. Cardiol. 45, 1037–1044PubMedCrossRefGoogle Scholar
  15. 15.
    Mason JW, O’Connel JB, Herskowitz A (1994) and the Myocarditis Treatment Trial Investigators. A clinical trial of immunosuppressive therapy for myocarditis. N Engl J Med; 321: 1061–1068Google Scholar
  16. 16.
    Ohlsen EGJ (1985) The problem of viral heart disease: How often do we miss it? Postgrad Med J; 61:479–480CrossRefGoogle Scholar
  17. 17.
    Parillo JE, Cunnion RE, Epstein SE, und Mitarb A (1989) Prospective, randomized, controlled trial of prednisone for dilated cardiomyopathy. N. Engl. J. Med. 321, 1061–1068CrossRefGoogle Scholar
  18. 18.
    Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on The Definition and Classification of Cardiomyopathies. Circulation 1996; 93: 841–842Google Scholar
  19. 19.
    Schultheiss HP, Ulrich G, Janda I, Kühl U, Morad M (1988) Antibody-mediated enhancement of calcium permeability in cardiac myocytes. J Exp Med; 168:2105–2119PubMedCrossRefGoogle Scholar
  20. 20.
    Schulze K, Becker BF, Schultheiß HP (1989) Antibodies to the ADP/ATP carrier, an autoantigen in myocarditis and dilated cardiomyopathy, penetrate into myocardial cells and disturb energy metabolism in vivo. Circ Res; 64:179–192PubMedGoogle Scholar
  21. 21.
    Schulze K, Becker BF, Schauer R, Schultheiss HP (1990) Antibodies to the ADP/ATP carrier — an autoantigen in myocarditis and dilated cardiomyopathy — impair cardiac function. Circulation 81, 959–969PubMedCrossRefGoogle Scholar
  22. 22.
    Shanes JG, Ghali J, Billingham ME, Ferrans VJ, Fenoglio JJ, Edwards WD, Tsai CC, Saffitz JE, Isner J, Fumer S, Subramanian R (1987) Interobserver variability in the pathologic interpretation of endomyocardial biopsy results. Circulation; 75:401–405PubMedCrossRefGoogle Scholar
  23. 23.
    Steenbergen C, Kolbeck PC, Wolfe JA, Anthony RM, Sanfilippo FP, Jennings RB (1986) Detection of lymphocytes in endomyocardium using immunohistochemical techniques. Relevance to evaluation of endomyocardial biopsies in suspected cases of lymphocytic myocarditis. J Appl Cardiol; 1:63–73Google Scholar
  24. 24.
    Wolff P, Kühl U, Schultheiss HP (1989) Laminin distribution and autoantibodies to laminin in dilated cardiomyopathy and myocarditis. Am Heart J; 117:1303–1309PubMedCrossRefGoogle Scholar
  25. 25.
    Zee-Cheng CS, Tsai CC, Palmer DC, Codd JE, Pennington DG, Williams GA (1984) High incidence of myocarditis by endomyocardial biopsy in patients with idiopathic congestive cardiomyopathy. J Am Coll Cardiol 3, 63–70PubMedCrossRefGoogle Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG, Darmstadt 1997

Authors and Affiliations

  • U. Kühl
    • 1
  • H.-P. Schultheiss
    • 1
  1. 1.Department of CardiologyFree University Berlin, Universitätsklinikum Benjamin FranklinBerlinGermany

Personalised recommendations