[Dilated cardiomyopathy: indication and role of non-invasive instrumental evaluation].
Typical morphological and functional abnormalities of dilated cardiomyopathy can be well evaluated non-invasively by the echocardiographic and echo-Doppler study. However it is important to remember that left ventricular dilation and depressed systolic function can be found also in other diseases that may mimic idiopathic dilated cardiomyopathy (coronary heart disease, myocarditis, biventricular dysplasia, advanced hypertrophic cardiomyopathy, hypertensive or valvular heart diseases). Unusual echocardiographic findings for dilated cardiomyopathy, i.e. a mildly dilated and/or hypertrophic left ventricle, segmental rather than diffuse wall motion abnormalities, predominant right ventricular dilation and dysfunction or severe valvular abnormalities should increase the clinical suspicion of a different disease. Transesophageal and dobutamine stress echocardiography can be employed in selected patients. However, for definitive diagnosis invasive hemodynamic study with coronary angiography and sometimes endomyocardial biopsy is often required. The diagnostic role of other non-invasive studies, such as magnetic resonance, computed tomography and nuclear techniques, is not well known, considering the cost and the limited availability of these clinical tools.
Pinamonti
Bruno
B
Struttura Complessa di Cardiologia, Azienda Ospedaliera Ospedali Riuniti, Piazza Ospedale, 1 34100 Trieste. bpinamonti@hotmail.com
Cacciatore
Giuseppe
G
D002309:Cardiology / Q000379:methods; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis*; D006801:Humans