title: Influence of different aetiologies on clinical course and outcome in patients with dilated cardiomyopathy.
abstract: BACKGROUND
  The clinical phenotype dilated cardiomyopathy is assumed to be the endstage of a multifactorial aetiopathogenetic pathophysiology which includes a not satisfactorily defined group of patients with inflammatory cardiomyopathy.
  
  
  METHODS
  Within the German Competence Network Heart Failure patients with heart failure due to dilated cardiomyopathy of viral/inflammatory (DCMi/v) and nonviral/noninflammatory (DCM) aetiology were enrolled. After 1 year 237 patients (180 male/57 female) were re-examined including complete clinical work-up. The association of different clinical courses with the time from initial diagnosis of heart failure (newly: ≤ 1 year; late: > 1 year) was investigated.
  
  
  RESULTS
  After 1-year-follow-up New York Heart Association (NYHA) class (by -0.48 in newly diagnosed DCM and -0.82 in newly diagnosed DCMi/v in addition to -0.24 in late diagnosed DCM and -0.17 in late diagnosed DCMi/v) as well as left ventricular ejection fraction (+14% in newly diagnosed DCM and DCMi/v and +6% in later diagnosed DCM and DCMi/v) were significantly improved in all patients. In patients with early diagnosed dilated cardiomyopathy a strong improvement of NYHA class could be demonstrated.
  
  
  CONCLUSIONS
  This study demonstrates for the first time a significant interaction between duration of disease, NYHA class and left ventricular ejection fraction in patients with DCM. Our results clearly demonstrate that in patients with DCM an early diagnosis within 1 year after occurrence of clinical signs is associated with a strong improvement in the clinical course, whereas late diagnosis results in a loss of change in clinical course and outcome.
authors.affiliation: Department of Internal Medicine - Cardiology, Angiology, Intensive Care and Prevention, University of Marburg, Marburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Pankuweit
authors.affiliation: Department of Cardiology, Klinikum Oldenburg, University of Oldenburg, European Medical School, Oldenburg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Lüers
authors.affiliation: Department of Internal Medicine - Cardiology, Angiology, Intensive Care and Prevention, University of Marburg, Marburg, Germany.
authors.forename: Anette
authors.initials: A
authors.lastname: Richter
authors.affiliation: Department of Internal Medicine - Cardiology, Angiology, Intensive Care and Prevention, University of Marburg, Marburg, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Ruppert
authors.affiliation: Institute of Clinical Epidemiology and Biometry (ICE-B), Julius Maximilian University of Würzburg, Würzburg, Germany.
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.affiliation: Herz- und Gefäßzentrum Marburg (HGZ), Marburg, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Maisch
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001794:Blood Pressure; D002311:Cardiomyopathy, Dilated / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D009205:Myocarditis / Q000150:complications* / Q000628:therapy / Q000821:virology; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D000960:Hypolipidemic Agents; D016756:Immunoglobulins, Intravenous; D000451:Mineralocorticoid Receptor Antagonists
keywords: Aetiology; dilated cardiomyopathy; epidemiology; heart failure; inflammation; myocarditis