From the Guidelines
Dilated cardiomyopathy (DCM), restrictive cardiomyopathy (RCM), and hypertrophic cardiomyopathy (HCM) are distinct cardiomyopathies with different morphological and functional characteristics.
Key Differences
- DCM is characterized by left ventricular or biventricular dilatation and systolic dysfunction in the absence of abnormal loading conditions or coronary artery disease 1.
- HCM is a unique cardiovascular disease with the potential for clinical presentation during any phase of life, characterized by hypertrophy of the myocardium 1.
- RCM is characterized by restrictive filling of the ventricles, often due to infiltrative diseases or other systemic conditions 1.
Key Similarities
- All three cardiomyopathies can present with heart failure, arrhythmia, and sudden death 1.
- They can have a genetic component, with some cases being familial or having a genetic basis 1.
- Clinical presentation can be variable, including dyspnea, edema, ascites, chest discomfort, palpitations, and syncope 1.
Diagnostic Considerations
- Multimodality imaging is essential in the diagnosis, risk stratification, and management of patients with cardiomyopathies 1.
- A dedicated diagnostic workup is necessary to identify the underlying cause of the cardiomyopathy and guide therapy 1.
Treatment Considerations
- Therapy should be tailored to the specific cardiomyopathy and underlying cause, with a focus on addressing the underlying pathophysiology and managing symptoms 1.
- Heart transplantation may be considered in advanced cases of cardiomyopathy, particularly in patients with DCM 1.
From the Research
Differences between DCM, RCM, and HCM
- DCM is characterized by systolic pump failure and dilatation of the ventricular cavity 2
- RCM is usually characterized by undilated ventricles associated with atrial enlargement 3
- HCM is characterized by asymmetric left ventricular hypertrophy and systolic anterior motion of the mitral valve with the obstructive phenotype 3
- The pathologic features of DCM, RCM, and HCM are distinct, with DCM showing dilated left ventricle with different degrees of systolic dysfunction, RCM showing undilated ventricles with atrial enlargement, and HCM showing asymmetric left ventricular hypertrophy 3, 2
Similarities between DCM, RCM, and HCM
- All three cardiomyopathies can be caused by genetic mutations, with some mutations being common to multiple cardiomyopathies 4, 5
- DCM and RCM can have a similar genetic background, with some cases of RCM potentially representing a part of the phenotypic spectrum of HCM 5
- All three cardiomyopathies can show diastolic dysfunction as a prevalent pathophysiological mechanism, particularly in the case of HCM and RCM 5
Diagnostic Features
- Echocardiography can identify diagnostic features of DCM, RCM, and HCM, and guide further testing for a definitive diagnosis 3
- Genetic testing can facilitate identification of potential risk factors for DCM, RCM, and HCM, particularly in cases with a family history of the disease 4, 5
- Establishing a correct etiological diagnosis among HCM, primary RCM, and hypertrophic or restrictive phenocopies is of paramount importance for cascade family screening and therapy 5