Risk stratification in nonischemic dilated cardiomyopathy: Current perspectives

The clinical goals of risk stratification of sudden death are to identify subjects who are at high risk of, and eventually to reduce the incidence of, sudden death. Numerous studies have described risk stratification techniques for serious cardiac events in patients following myocardial infarction. However, relatively little information is available regarding nonischemic dilated cardiomyopathy. A number of diagnostic methods have been used for risk stratification of patients with nonischemic dilated cardiomyopathy, including presence of syncope, ambulatory electrocardiographic monitoring, programmed ventricular stimulation, QRS duration, QT interval dispersion, QT interval dynamicity, signal-averaged ECG, heart rate variability, heart rate turbulence, baroreflex sensitivity, heart rate recovery, exercise recovery ventricular ectopy, fragmented QRS and cardiac magnetic resonance imaging. In this review, existing data regarding risk stratification of sudden cardiac death in nonischemic dilated cardiomyopathy will be summarized and its implications in clinical practice will be reviewed. (Cardiol J 2010; 17, 3: 219-229