DILATED CARDIOMYOPATHY

The etiology and pathogenesis of dilated cardiomyopathy continues to b e controversial. The importance of viral and familial etiologies is be coming increasingly recognized. Molecular biology will add significant ly to our understanding of these factors in the near future. The diffe rentiation of ischemic from nonischemic dilated cardiomyopathy continu es to depend on the use of coronary angiography. Endomyocardial biopsy has a relatively low yield for the detection of specific myocardial d isease. To date, there is no specific treatment for dilated cardiomyop athy. Trials evaluating new inodilators have ended in disappointment. The benefits of digoxin, however, appear to be confirmed. Although the re has been little progress in the prevention of sudden cardiac death in this population, signal-averaged electrocardiographic analysis show s promise as a tool for risk stratification. At present, the recommend ed treatment of patients with dilated cardiomyopathy remains identical to that of heart failure in general.