Patients who have dilated cardiomyopathy must have a trial of bridge to recovery: the case against that proposition.
The idea that patients who have dilated cardiomyopathy (presumably a large heart with near-normal coronary arteries) must have a trial of bridge to recovery is risible. Many such patients should be managed so that they go directly to transplantation and others may be better treated with drug therapy. Some may be more suited to destination therapy. What is needed in this field is more precise terminology, clearer statements of clinical intent at the time of device insertion, improved characterization of patients, more accurate clinical assessment, and above all more information from randomized clinical trials.
Poole-Wilson
Philip A
PA
National Heart & Lung Institute, Imperial College London, London, UK. p.poole-wilson@imperial.ac.uk <p.poole-wilson@imperial.ac.uk>
D015415:Biomarkers / Q000032:analysis; D001783:Blood Flow Velocity; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000601:surgery*; D000075202:Contraindications; D006334:Heart Function Tests; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery*
D015415:Biomarkers