Cardiomyopathies and the role of imaging: early detection and risk stratification

[...]. DCM : Definition and epidemiology • Dilated cardiomyopathy (DCM) is defined by the presence of LV dilatation and contractile dysfunction, in the absence of abnormal loading conditions and severe coronary artery disease • DCM is one of the most common with an estimated prevalence of 40 cases per 100,000 individuals and an annual incidence of 7 cases per 100,000 individuals • DCM is the most common indication for heart transplantation worldwide. DCM : Echocardiography Juliani PS, et al, Circ Cardiovasc Imaging 2014; Lang RM, et al, J Am Soc Echocardiogr 2015 • Impairment of contractile performance and EF ≤45% are evidence of DCM • Global hypokinesia, thinned walls and chamber enlargement are typical features • Inter-observer variability – 10%. DCM : Echocardiography D de Gonzalo-Calvo, et al, Int J Cardiol 2017 • RV dysfunction has been reported in ∼65% of patients with DCM and these patients tend to have a worse prognosis • DCM and pulmonary hypertension lead to more severe symptoms, a greater increase in BNP levels, more severe MR and diastolic dysfunction • The presence of a secondary MR predicts a poor outcome • Diastolic dysfunction contributes to symptoms of HF and provides important diagnostic and prognostic information[...]