How is dilated cardiomyopathy investigated in Scotland? A contemporary survey.

BACKGROUND AND AIMS

Dilated cardiomyopathy (DCM) is a common cause of heart failure. The underlying aetiology remains poorly characterised, with ca. 50% labelled 'idiopathic'. We assessed the extent to which the aetiology of DCM is investigated in Scotland, in comparison to European Society of Cardiology (ESC) recommendations.

METHODS AND RESULTS

Questionnaires regarding the use of coronary angiography, use and availability of cardiac magnetic resonance imaging (CMR) and blood/urine panels to investigate the causes of DCM were sent to the heart failure lead in each of the 23 hospitals across Scotland with an established cardiology department; responses were obtained from 21/23 (91.3%). ESC guidelines regarding coronary angiography were adopted in only 8/21 (38.1%). Only 7/21 (33.3%) had easy access to CMR although 14/21 (66.7%) felt it would be a useful test in DCM. The ESC-recommended blood profile was checked routinely in 7/21 (33.3%). Additional blood tests, many of which not currently recommended, were performed in selected centres.

CONCLUSIONS

DCM patients in Scotland are in general unlikely to undergo current ESC-recommended investigation into the underlying aetiology. There is a need for prospective studies to determine the success rate and influence on management and outcome of such multifaceted approaches to investigating the cause of DCM.