Mildly Dilated Cardiomyopathy

Abstract

Dilated cardiomyopathy is considered a disease of uncertain and probably heterogeneous origin, characterized by dilatation and impaired systolic function of the left or both ventricles [1]. Although this definition underscores the typical pathological aspect of dilated cardiomyopathy, there is increasing evidence that a larger spectrum of morphological conditions can be included in this unexplained heart muscle disease. In fact, patients with impairment of systolic function of unknown cause show a wide range of left ventricular dimensions, from very enlarged to absolutely normal chambers [2]. In the past, different studies attributed a prognostic significance to the degree of left ventricular dilatation, that was considered as one of the factors predicting mortality in patients with dilated cardiomyopathy [3–6]. However, other observations on small series have recently shown that patients with an idiopathic reduction of contractility may have an unfavorable outcome despite the absence of relevant left ventricular enlargement [7,8]. Moreover, a preliminary analysis of 144 patients enrolled in the SPIC (Italian Multicentric Study on Cardiomyopathies) Registry and followed up for about three years did not confirm the role of ventricular dilatation as an independent negative prognostic factor [9].