EPIDEMIOLOGY OF DILATED CARDIOMYOPATHY - A PROSPECTIVE POSTMORTEM STUDY OF 5252 NECROPSIES

Dilated cardiomyopathy is a heart muscle disease of unknown aetiology, characterized by left ventricular dilatation and impaired systolic fu nction. Data on the incidence and prevalence of the disease is ambiguo us, due to geographic variations, patient selection and the diagnostic criteria adopted. Methods All the post-mortem and clinical cases obse rved in a consecutive series of 5252 patients resident in Trieste duri ng the period November 1987-November 1989 were studied. Results Incide nce of the disease discovered at autopsy was estimated at 4 . 5/100 00 0/year (24 cases), while clinical incidence in the same period was 2 . 45/100 000/year (13 cases). This is a total incidence of 6 . 95/100 0 00 new cases a year. A possible family history of heart muscle disease was found in three patients (12 . 5%). In 15 patients (62 . 5%) death s were due to cardiological complications. Endocardial thickening (P=0 . 03), fatty infiltration (P=0 . 01) and arterial involvement (P=0 . 04) were found more frequently in older patients (>65 years). Conclusi ons The study confirms that dilated cardiomyopathy in Europe has a hig her incidence than previously suggested and emphasizes the need for gr eater diagnostic sensitivity, particularly since pharmacological treat ment is now so effective.