Materiały źródłowe

• #1 Dilated cardiomyopathy – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dilated-cardiomyopathy/diagnosis-treatment/drc-20353155

  Treatment of dilated cardiomyopathy depends on the causes. The goals of treatment are to reduce symptoms, improve blood flow and prevent further heart damage. Dilated cardiomyopathy treatment may include medications or surgery to implant a medical device that helps the heart beat or pump blood. […] A combination of medications may be used to treat dilated cardiomyopathy and prevent any complications. Medications are used to: Control the heart’s rhythm, Help the heart pump better, Lower blood pressure, Prevent blood clots, Reduce fluid from the body. […] Surgery may be needed to implant a device to control the heart’s rhythm or help the heart pump blood. Type of devices used to treat dilated cardiomyopathy include: Biventricular pacemaker, Implantable cardioverter-defibrillators (ICD), Left ventricular assist devices (LVAD). […] If medications and other treatments for dilated cardiomyopathy no longer work, a heart transplant may be needed.

• #2 Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Blood Pressure Control, Angiotensin-Converting Enzyme Inhibitors

  https://emedicine.medscape.com/article/152696-treatment

  Treatment of dilated cardiomyopathy (DCM) is essentially the same as treatment of chronic HF, a complex clinical syndrome for which many treatment modalities have emerged. Research into the biochemical alterations that occur in persons with cardiomyopathies has led to the development of many medications designed to affect these alterations. Some therapeutic interventions treat symptoms, whereas others treat factors that affect survival. […] Drug classes used to manage cardiomyopathies include, but are not limited to, the following: Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers (ARBs), Beta-blockers, Aldosterone antagonists, Cardiac glycosides, Diuretics, Nitrates, Vasodilators, Sacubitril/valsartan (ARNI), Ivabradine, Antiarrhythmics, Human B-type natriuretic peptide, Inotropic agents, Anticoagulants (may be used in selected patients).

• #3 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy

  Treatment is directed at the cause. Standard heart failure treatment measures are used (eg, angiotensin-converting enzyme inhibitors, beta-blockers, aldosterone receptor blockers, angiotensin II receptor blockers, ARNI [angiotensin II receptor blocker and neprilysin inhibitor], sodium glucose cotransporter 2 protein [SGLT2] inhibitors, hydralazine/nitrates, diuretics, digoxin). If heart failure is progressive and severe, cardiac resynchronization therapy, implantable cardioverter-defibrillator, repair of moderate to severe valvular regurgitation, left ventricular assist device, or heart transplantation may be needed. […] Treatable causes (eg, toxoplasmosis, acute Chagas disease, hemochromatosis, thyrotoxicosis, thiamin deficiency) are corrected. Patients with HIV infection should have antiretroviral therapy (ART) optimized. Treatment with immunosuppression should be limited to patients with biopsy-proven giant cell myocarditis, eosinophilic myocarditis, sarcoidosis, or other autoimmune causes (eg, systemic lupus erythematosus).

• #4 Dilated Cardiomyopathy: Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy

  Fortunately, treatments are available for this heart condition. And there are things you can do to help manage this condition. […] You may need a variety of dilated cardiomyopathy treatments. In most cases, they wont cure the disease, but they can help you manage the symptoms and live longer. Treating dilated cardiomyopathy may involve medicines, changes to your lifestyle or surgeries. The earlier you start treatment, the better your prognosis (outcome). Your cardiologist or heart failure specialist will work with you to find the right combination of these medicines. […] Medications that improve your heart function with dilated cardiomyopathy include: ACE inhibitors, Aldosterone antagonists, Angiotensin receptor/neprilysin inhibitors (ARNI), Antiarrhythmics to treat abnormal heart rhythms, Beta-blockers, Blood thinners (anticoagulants) for people with atrial fibrillation, Diuretics.

• #5 Current Management and Treatment – Dilated Cardiomyopathy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553842/

  The prevalence of heart failure (HF) is escalating rapidly, consuming significant healthcare resources, inflicts significant morbidity and mortality, and greatly impacts quality of life. Dilated cardiomyopathy (DCM) is a frequent cause of HF and is characterized by a progressive course. Nowadays pharmacological and non-pharmacological therapies have dramatically changed DCMs natural history. […] Patients with a clinical diagnosis of HF and LV dysfunction should receive recommended therapies: beta-blockers (BB), ACE inhibitors (ACEi) or angiotensin receptor blockers (ARB), aldosterone antagonists, and more recently angiotensin receptor-neprilysin inhibitor (ARNI) and ivabradine are established therapies for chronic HF. […] Finally, heart transplantation and mechanical circulatory support (MCS) are options that can be used in critically ill HF who cant be stabilized by medical therapy alone.

• #6 Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Blood Pressure Control, Angiotensin-Converting Enzyme Inhibitors

  https://emedicine.medscape.com/article/152696-treatment

  Appropriate control of blood pressure is essential to effective therapy for persons with HF. The systolic blood pressure must be less than 120 mm Hg (preferably less than 110 mm Hg). […] Use of angiotensin-converting enzyme (ACE) inhibitors has been the criterion standard in the treatment of left ventricular dysfunction. ACE inhibitors have been shown to decrease mortality in both symptomatic and asymptomatic patients with left ventricular dysfunction and to reduce readmissions caused by HF. […] The dosage necessary for maximal benefit has been a matter of debate. […] Data have demonstrated that angiotensin II receptor blockers (ARBs) are as effective as angiotensin-converting enzyme (ACE) inhibitors in the treatment of HF. […] Previously believed to be contraindicated in patients with left ventricular dysfunction, this class of medications has moved to the forefront of HF treatment. Several trials have shown that beta-blockers are both safe and effective in the treatment persons with any class of HF and that adding beta-blockers to outpatient management of chronic HF yields great reductions in mortality.

• #7 Dilated Cardiomyopathy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18918

  Besides treating any identifiable and reversible underlying causes, the management and treatment of Dilated Cardiomyopathy (DCM) are in concordance with the standard heart failure guidelines. […] In patients with acute congestive heart failure exacerbation, intravenous loop diuretics are given to treat hypervolemia. Management of chronic and stable disease with oral diuretics often is needed to achieve a euvolemic state. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) have shown benefit in the treatment of heart failure with reduced ejection fraction and are recommended in patients with DCM. Aldosterone receptor blockade with spironolactone or eplerenone also is recommended in patients with New York Heart Association (NYHA) heart failure class II-IV and systolic dysfunction. Similarly, beta-blockade with carvedilol, bisoprolol, or long-acting metoprolol is recommended in all patients with heart failure with reduced ejection fraction without any contraindications. The addition of isosorbide dinitrate plus hydralazine also has shown to increase survival amongst those with advanced disease.

• #8 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy

  Otherwise, treatment is the same as for heart failure with reduced ejection fraction: angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, aldosterone receptor blockers, angiotensin II receptor blockers, ARNI (angiotensin II receptor blocker and neprilysin inhibitor), sodium glucose cotransporter 2 protein (SGLT2) inhibitors, hydralazine/nitrates, diuretics, and digoxin. […] Special precautions are needed in the treatment of peripartum cardiomyopathy. Many medications (eg, ACE inhibitors and angiotensin II receptor blockers) should be avoided during pregnancy due to the risk of fetal harm. In addition, these medications are not recommended for women who are breastfeeding. […] Medical treatment of heart failure reduces risk of arrhythmia, but an implantable cardioverter-defibrillator may be used to prevent death due to sudden arrhythmia in patients who continue to have a reduced ejection fraction despite optimal medical therapy.

• #9

  https://link.springer.com/article/10.1007/s40268-023-00435-5

  At present, the therapies of dilated cardiomyopathy concentrated on the symptoms of heart failure and related complications. […] A combination of different medications and conventional therapy may increase the clinical effectiveness of treating dilated cardiomyopathy. Beta-blockers, especially carvedilol, can improve ventricular remodeling, cardiac function, and clinical efficacy in patients with dilated cardiomyopathy (DCM). Hence, they can be used if patients tolerate them. […] This study also included other adjuvant drugs for DCM treatment, among which l-thyroxine, LMWH, and pentoxifylline showed remarkable efficacy. […] According to this study, conventional therapy ranked lower in the multi-group comparison of multiple outcome measures mentioned above. This finding demonstrated that combining adjuvant medicines with conventional therapy might be more effective than conventional therapy alone in improving DCM.

• #10 Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Blood Pressure Control, Angiotensin-Converting Enzyme Inhibitors

  https://emedicine.medscape.com/article/152696-treatment

  Spironolactone acts as an aldosterone receptor blocker and, with concomitant use of angiotensin-converting enzyme (ACE) inhibitors, helps break the cycle of sodium retention and fluid overload via the renin-aldosterone axis. […] Loop diuretics are necessary adjuncts in the medical therapy for HF when symptoms are due to sodium and water retention. […] Antiarrhythmics are useful in patients with supraventricular and nonsustained ventricular tachycardias. […] In 1986, the US Veterans Administration Cooperative study showed a 36% mortality risk reduction in patients treated with preload and afterload reducers (eg, isosorbide dinitrate, hydralazine) in addition to conventional HF medications. […] Human B-type natriuretic peptide (BNP) (nesiritide [Natrecor]) is a relatively new class of drug in the treatment of HF.

• #11 Current Management and Treatment – Dilated Cardiomyopathy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553842/

  DCM is a common cause of HF and treatment reflects the management of chronic HF. DCM patients, indeed, can be divided into two different classes on the base of the presence of clinical symptoms: […] Pharmacologic and device therapy should be primarily accompanied by the management of contributing factors of HF and by lifestyle modification. […] For patients with symptomatic HF, a new therapeutic algorithm has been proposed by the current European guidelines. […] More recently, two new molecules have been included to the recommended pharmacological therapy: an angiotensin receptor-neprilysin inhibitor (ARNI) and the hyperpolarization channel blocker ivabradine. […] Diuretic therapy is intended to reduce symptoms and signs of congestion, but no clinical trial could demonstrate any effect on morbidity and mortality.

• #12 Pediatric Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Pharmacologic Therapy, Palliative, Bridge, and Experimental Surgery

  https://emedicine.medscape.com/article/895187-treatment

  Support exists for the use of ivabradine in the management of DCM-associated heart failure in children. […] Anticoagulants and antiarrhythmic agents, particularly amiodarone, are often used in patients with low myocardial contractility and symptomatic arrhythmias, respectively. […] Palliative surgical measures are associated with significant mortality and morbidity rates despite advances. […] Implantable mechanical support devices, modified for use in infants and children, have been introduced to support the failing heart until a suitable donor is available for transplantation (bridge to transplant). […] Cardiac resynchronization therapy using a biventricular pacemaker has been shown to be effective in adults with DCM. […] A potential therapeutic option in children with DCM may be prophylactic pulmonary artery banding as a bridge or alternative to heart transplantation.

• #13 Treatments for DCM – DCM Foundation

  https://dcmfoundation.org/living-with-dcm/treatments-for-dcm/

  SGLT2 inhibitors: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are the fourth category of medications that provide benefit to people with DCM and reduced ejection fraction of 40% or less. […] Your doctor may change your medications or the amount of current medications for several reasons. […] In every case, any concerns about the medication or the side effects of medications should be discussed with your doctor.

• #14 Metabolic Approaches for the Treatment of Dilated Cardiomyopathy

  https://www.mdpi.com/2308-3425/10/7/287

  The failing heart is considered to be an “engine out of fuel.” […] The reduction in the mitochondrial oxidative capacity is the first metabolic change characterizing the heart’s deteriorating energy deficiency. […] The improvement in overall cardiac function seen in patients receiving SGLT2i could be explained by this increase, which appears to be a reflection of an adaptive process that optimizes cardiac energy metabolism. […] The potential routes of action include elevated skeletal muscle blood flow, bradykinin build up, or more effective insulin release. […] The hormone system known as RAAS controls blood pressure and fluid balance. […] The specific cause of this is still unknown. […] A better knowledge of cardiac metabolic adaptations in HF would certainly serve as a starting point from which to highlight new therapeutic targets, for old and new drugs, to exploit in different phenotypes and disease stages.

• #15 Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Blood Pressure Control, Angiotensin-Converting Enzyme Inhibitors

  https://emedicine.medscape.com/article/152696-treatment

  Long-term use of the phosphodiesterase inhibitor milrinone has deleterious effects on survival in patients with HF. […] Restrict the use of anticoagulants to those patients in atrial fibrillation, with artificial valves, or with known mural thrombus. […] Implantable left ventricular assist devices (LVADs) have been proven as a standard of care for suitable candidates with advanced HF when a bridge to transplantation (BTT) is needed. […] For biventricular pacing, a pulse generator is implanted under the skin, with leads positioned in the right atrium, right ventricle, and coronary sinus to pace the left ventricle. […] Automatic implantable cardioverter-defibrillators (AICDs) are designed to detect and correct ventricular tachycardia/ventricular fibrillation. […] When progressive end-stage HF occurs despite maximal medical therapy, when the prognosis is poor, and when there is no viable therapeutic alternative, the criterion standard for therapy has been heart transplantation.

• #16 Dilated Cardiomyopathy (DCM): Symptoms, Causes, Treatment, Outlook

  https://www.healthline.com/health/heart-disease/dilated-cardiomyopathy

  For some individuals, device therapy may be necessary to strengthen and protect the heart. Examples of this include an implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT). […] Individuals with DCM and certain arrhythmias or a mechanical artificial heart valve should also take anticoagulant medication to reduce the risk of blood clots forming. […] If DCM has resulted in severe heart failure, then the implantation of a left ventricular assist device (LVAD) may be necessary. This helps a weakened heart to pump blood throughout the body. […] LVAD is often used as a bridge to a heart transplant, but in recent years, LVAD technology has proven to be reliable enough that many people use LVAD permanently.

• #17 Current Management and Treatment – Dilated Cardiomyopathy – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK553842/

  Finally, in case of intolerance or contraindication to ACEi or ARB, combination of hydralazine and isosorbide dinitrate (not approved in Italy) in symptomatic patients with HF and reduced LVEF has demonstrated to reduce mortality. […] Cardioactive pharmacological drugs should be adjusted and up-titrated every 2 weeks to the maximally tolerated doses that should be achieved within 36 months from initial diagnosis of HF. […] Prophylactic implantation of an ICD is a class I recommendation for patients with nonischemic dilated cardiomyopathy (NIDCM), symptomatic HF with NYHA class IIIII, and an LVEF 35%. […] Mechanical circulatory support (MCS) devices can be used in critically ill HF patients who cant be stabilized by medical therapy alone. […] Heart transplantation (HT) is a well-recognized treatment that significantly increases quality of life and survival for eligible patients with advanced HF, severe symptoms, poor prognosis, and no remaining alternative choices.

• #18

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=hw52466

  Treatment for dilated cardiomyopathy focuses on relieving your symptoms, improving heart function, and helping you live longer. You may also have treatment for the cause of the cardiomyopathy. […] You will probably need to take several medicines. They include: Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). These make it easier for blood to flow. Diuretics. These help remove excess fluid from the body. Beta-blockers. These slow the heart rate and can help the heart fill with blood more completely. […] It’s very important to take your medicines exactly as your doctor tells you to. And make sure to keep taking them. If you don’t, your heart function could get worse. […] Your doctor may suggest a mechanical device to help your heart pump blood or to prevent life-threatening irregular heart rhythms. These devices include: A pacemaker for heart failure (also called cardiac resynchronization therapy or CRT). An implantable cardioverter-defibrillator (ICD). A combination pacemaker and ICD. […] If your condition is very bad, a heart transplant may be an option. […] If the cause of dilated cardiomyopathy can be treated, this can slow or stop the progression of the disease. For some types of cardiomyopathy, treatment can help the heart work better.

• #19 Dilated Cardiomyopathy: Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/16932-dilated-cardiomyopathy

  Changes to your daily routine can improve how well medications work and possibly help you delay or avoid the need for a procedure. […] You may need a procedure or surgery if you have advanced dilated cardiomyopathy and limited heart function. Procedures for dilated cardiomyopathy treatment include: Biventricular pacemaker to help your heart pump more regularly, Implantable cardioverter defibrillator (ICD) to send a shock that returns your heart rhythm to normal when you need it, Heart failure surgery or heart valve surgery to improve your heart function, Left ventricular assist device (LVAD) to help your weakened heart muscle pump blood, Heart transplant (a rare option for when other treatments dont work). […] No one wants to learn that their heart isnt working as well as it should. But today, healthcare providers can offer various treatments to help your heart work better if you have dilated cardiomyopathy. And there are simple changes you can make to improve your situation, too.

• #20 Prevention and Treatment of Cardiomyopathy | American Heart Association

  https://www.heart.org/en/health-topics/cardiomyopathy/prevention-and-treatment-of-cardiomyopathy

  People who have cardiomyopathy, but no signs or symptoms, may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. […] In other instances, treatment is needed. Treatment hinges on a few factors: […] When treating cardiomyopathy, objectives include: […] Treatment for cardiomyopathy may include one or more of the following: […] Lifestyle changes may help manage a condition that’s causing your cardiomyopathy. […] Many medications are used to treat cardiomyopathy. Depending on the type of cardiomyopathy, your health care professional may prescribe medicines to: […] A range of surgical and nonsurgical procedures can be used to treat cardiomyopathy: […] A heart transplant is a last resort for people who have end-stage heart failure. (End-stage means that all other treatment options have been explored, without success.) […] Treating that initial problem early may help prevent the complications presented by cardiomyopathy.

• #21 Dilated Cardiomyopathy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18918

  Finally, patients with disease refractory to maximum medical therapy should be considered for cardiac transplantation and LVAD as a bridge or for „destination” therapy in those who are not candidates for transplantation. Implanted cardioverter defibrillators (ICD) for primary prevention of sudden cardiac death and cardiac resynchronization therapy (CRT) can be considered and are recommended by the heart failure guidelines. […] A heart transplant is an option but the lack of donors is a major stumbling block. Indications for a heart transplant include refractory cardiogenic shock, ventricular arrhythmias, dependence on high levels of inotropes and dependency on an IABP or a ventricular assist device.

• #22 Dilated Cardiomyopathy – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/cardiomyopathies/dilated-cardiomyopathy

  Patients with refractory heart failure despite treatment may become candidates for heart transplantation. Selection criteria include absence of associated systemic disorders and psychologic disorders and high, irreversible pulmonary vascular resistance; because donor hearts are scarce, younger patients (usually 70 years) are given higher priority. Left ventricular assist devices (LVAD) may also be considered as a bridge to heart transplantation or as destination therapy in some patients (eg, patients who are not eligible for heart transplantation).

• #23

  https://step2.medbullets.com/cardiovascular/121586/dilated-cardiomyopathy

  Cessation of alcohol for all patients. […] Operative: automatic implantable cardioverter/defibrillator (AICD) indications: ejection fraction, biventricular pacemaker indications: QRS 120 ms, with a widened QRS, the 2 ventricles are not in synchrony, a biventricular pacemaker will resynchronize the 2 ventricles, heart transplant: the only definitive treatment.

• #24 Dilated Cardiomyopathy (DCM) Treatment & Management: Approach Considerations, Blood Pressure Control, Angiotensin-Converting Enzyme Inhibitors

  https://emedicine.medscape.com/article/152696-treatment

  The importance of patient education cannot be overemphasized, especially regarding dietary restrictions. […] Benefits of cardiac rehabilitation include a 20-30% reduction in all-cause mortality; decreased mortality up to 5 years following rehabilitation; reduced symptoms of dyspnea, angina, and fatigue; reduction in nonfatal recurrent myocardial infarction over follow-up period of 12 months; and increased exercise performance.

• #25 Managing Your Dilated Cardiomyopathy – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/heart-and-vascular-conditions/dilated-cardiomyopathy

  DO call your health care provider if you have new or worsening chest pain, shortness of breath, swelling in the legs, or fainting. […] DONT drink alcohol. […] DONT do strenuous exercise until your health care provider says that you can. […] DONT abuse drugs. Cocaine, heroin, and organic solvents such as glue can cause dilated cardiomyopathy.

• #26 Dilated cardiomyopathy: Signs, causes, and treatment

  https://www.medicalnewstoday.com/articles/dilated-heart-disease

  These devices include pacemakers or defibrillators to manage heart rhythm and support heart function. […] In severe cases, doctors may consider a heart transplant when other treatments have not worked. […] People with DCM can enroll in a cardiac rehabilitation program. This is a structured program that helps people with diet, exercise, and understanding their condition. With regular participation, cardiac rehabilitation can lower the risk of death by 20%. […] Treatment may involve a combination of prescription treatments, lifestyle changes, and, in severe cases, surgical interventions. The effectiveness of these treatments and proactive disease management can substantially improve a persons outlook and quality of life.

• #27 Shifting Paradigms in Dilated Cardiomyopathy Treatment

  https://www.delveinsight.com/blog/evolving-dilated-cardiomyopathy-treatment

  The emerging treatment strategies for DCM are based on regenerative medicine approaches, such as stem cell therapy and gene therapy that have the potential to repair and restore myocardia functioning in patients. […] Gene therapy, involving the introduction of foreign genes into cells, has shown promise in treating diseases like DCM and inherited disorders. […] Myosin heavy chain, a key protein in cardiac sarcomere, is a potential drug target for DCM patients. […] CRISPR activation of the TTN gene has shown promise in reversing haploinsufficiency and addressing functional deficits caused by TTN truncation variants, a common genetic cause of DCM. […] Another promising approach involves using CRISPR gene editing technology to reverse mutations in genes such as RNA binding motif protein 20 (RBM20), which are also associated with DCM. […] Stem cell therapy involves transplanting stem cells into the heart to improve cardiac function. Research indicates that stem cell transplantation can improve left ventricular ejection fraction (LVEF), increase exercise capacity, and alleviate symptoms of heart failure in patients with DCM.

• #28 Dilated Cardiomyopathy: A New Era of Treatment

  https://fortuneonline.org/articles/dilated-cardiomyopathy-a-new-era-of-treatment.html

  The current optimal medical therapy for DCM includes beta-blockers, angiotensin receptor-neprilysin inhibitors/angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter-2 inhibitors. […] Implantable cardiac devices play a crucial role in the management of different phenotypes of heart failure by treating life-threatening arrhythmias and improving morbidity and survival. […] Gene therapy is the insertion of a gene into a human cell to treat a disease. […] The advent of induced pluripotent stem cells (iPSCs) provides the development of disease-specific cellular models and, with that, the investigation of underlying mechanisms and optimization of therapy. […] Patients with advanced heart failure due to DCM should be referred to specialized centers capable of providing appropriate treatment. Mechanical circulatory support and/or heart transplantation can offer improved survival and quality of life.

• #29 Stem Cell Treatment for Dilated Cardiomyopathy: A Review of Recent Scientific Advances | Published in Georgetown Medical Review

  https://gmr.scholasticahq.com/article/123163-stem-cell-treatment-for-dilated-cardiomyopathy-a-review-of-recent-scientific-advances

  Because existing management strategies for DCM are not able to fully prevent patients from progressing to heart failure, the use of stem cells offers a promising alternative. […] While stem cell therapy is a rapidly evolving area of research, several methods of stem cell derivation have proven particularly effective in the treatment of DCM. […] Because DCM often causes diffuse dilation, aspects of HSC therapy on other regions of the heart have shown similar promise. […] With minimal results available to support the efficacy of HSCs as a stand-alone treatment for ischemic DCM, Assmann et al looked to combine stem cell treatment with surgical measures in patients with ischemic DCM. […] Mesenchymal stem cells (MSCs) are another area of prominent therapeutic research for cardiomyopathies such as DCM.

• #30 Stem Cell Treatment for Dilated Cardiomyopathy: A Review of Recent Scientific Advances | Published in Georgetown Medical Review

  https://gmr.scholasticahq.com/article/123163-stem-cell-treatment-for-dilated-cardiomyopathy-a-review-of-recent-scientific-advances

  Considering that the pathology of nonischemic cardiomyopathy largely relates to endothelial dysfunction, the significant effects of allogeneic MSCs on the patients likely resulted from the considerable effects on EPC-CFU and TNF- concentration. […] Finally, a study by Florea et al assessed the necessary dosage of transplanted allogeneic MSCs to elicit a therapeutic response. […] While the use of stem cells for cardiomyopathy is a promising therapeutic possibility that has garnered significant interest over the past decade, some researchers have voiced concerns about possible drawbacks to this type of therapy as a whole. […] Moving forward, research in this field will hopefully continue to walk the line of maximizing therapeutic benefits while minimizing these potential drawbacks such that stem cell therapy is someday available as a curative treatment to individuals with DCM.

• #31 Shifting Paradigms in Dilated Cardiomyopathy Treatment

  https://www.delveinsight.com/blog/evolving-dilated-cardiomyopathy-treatment

  While current dilated cardiomyopathy treatments focus on controlling symptoms and improving heart function, there is a need for more innovative approaches to address the underlying causes of DCM and improve patient outcomes. […] Personalized medicine approaches focus on customizing dilated cardiomyopathy treatments for individual patients based on their unique genetic profiles, disease mechanisms, and therapy responses. These may include gene therapy, gene editing, and targeted treatments. This approach offers several advantages, including improved efficacy and reduced side effects. Personalized dilated cardiomyopathy treatment can be designed to target specific genetic mutations or disease mechanisms, increasing the likelihood of effective therapy. Additionally, personalized dilated cardiomyopathy treatment can help identify patients who are most likely to benefit from a particular therapy, reducing the risk of ineffective or harmful treatments as well as more precise monitoring and adjustment of treatment, enabling clinicians to optimize therapy over time.

• #32 Therapy withdrawal in REcovered Dilated cardiomyopathy trial (TRED) – Health Research Authority

  https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/therapy-withdrawal-in-recovered-dilated-cardiomyopathy-trial-tred/

  If it is safe, we will go on to perform a larger study looking at the impact of withdrawing medications in the long-term. This work aims to answer a question that is important to both patients and doctors. […] However, there was no evidence showing that stopping heart failure treatment in this situation is safe, or if this would lead to symptoms returning. The Therapy withdrawal in REcovered Dilated cardiomyopathy Heart Failure (TRED-HF) trial led by Dr Sanjay Prasad at the Royal Brompton Hospital, Imperial College London, and funded by the BHF, was conducted to help address this important clinical dilemma. […] The researchers recommended that heart failure treatment was restarted in all participants at the end of the trial, even in the 16 people with successful withdrawal. This was due to the risk of relapse in the long-term.

• #33 Therapy withdrawal in REcovered Dilated cardiomyopathy trial (TRED) – Health Research Authority

  https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/therapy-withdrawal-in-recovered-dilated-cardiomyopathy-trial-tred/

  This trial showed for the first time that it is not advisable to withdraw heart failure medication in many people with DCM, even if they are asymptomatic. […] This study provided invaluable evidence to back-up long term prescription of medication in people with DCM, even if their heart failure seems to have recovered.

• #34 Dilated Cardiomyopathy | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/dilated-cardiomyopathy.html

  Your medical team may recommend medications to stabilize or improve your heart function. If dilated cardiomyopathy runs in your family, medications may help prevent the enlargement of your heart. […] To keep your heartbeat normal, your medical team may recommend a pacemaker, which is an implanted device that uses electricity to regulate your heartbeat. […] In rare cases, advanced dilated cardiomyopathy may lead to severe heart failure, which requires more significant interventions such as a left ventricular assist device (LVAD) or heart transplant. […] Our team includes psychologists who are specially trained in the needs of cardiovascular patients. These experts provide behavioral therapy and other services to promote your resilience and help you adjust to your diagnosis. […] Clinical trials for dilated cardiomyopathy test new treatments. When appropriate, these studies may provide you with a chance to try the latest treatment options.

• #35 Dilated Cardiomyopathy Causes Symptoms and Treatment

  https://www.sakraworldhospital.com/blogs/dilated-cardiomyopathy/424

  While there is no cure for DCM, early diagnosis and appropriate treatment can help manage symptoms, improve heart function, and prevent complications. Treatment options include: […] Medications are typically the first line of treatment for DCM. They aim to reduce symptoms, prevent complications, and improve heart function: […] Adopting a healthy lifestyle is essential for managing DCM. Key changes include: […] In some cases, medical devices may be used to support the heart: […] For patients with end-stage DCM and severe heart failure who do not respond to other treatments, a heart transplant may be considered as a last resort. […] appropriate treatment with medications, lifestyle changes, and medical devices can help improve heart function and quality of life. Early detection is key to managing the condition and preventing complications, so individuals experiencing symptoms like shortness of breath, fatigue, or irregular heartbeats should consult with a healthcare provider.

• #36 Cardiomyopathy: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/16841-cardiomyopathy

  Cardiomyopathy treatments dont cure the condition. However, they can help you manage your symptoms and slow down the diseases progression. Your healthcare provider may recommend lifestyle changes, medications, devices or procedures. Theyll decide your treatment based on which type of cardiomyopathy you have and how advanced it is. […] Treatment can help. Some people with cardiomyopathy eventually need a heart transplant. […] Cardiomyopathy treatment can improve your outlook. If you have cardiomyopathy, seek treatment from a cardiologist (heart specialist). Medication, procedures or other treatments can increase your quality of life and help you live longer. […] Theres no cure for cardiomyopathy. However, you can manage the condition or slow its progression. Many people who make healthy lifestyle choices and seek medical treatment can live a high quality of life with cardiomyopathy. Taking the proper medications can drastically alter and improve the prognosis of cardiomyopathy. Many people can live normal and healthy lives with the right treatment.

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