Merlo M, Caiffa T, Gobbo M, Adamo L, Sinagra G
Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, University of Trieste (ASUITS), Trieste, Italy.
Cardiovascular Division, Department of Medicine, Washington University School of Medicine St. Louis, MO, USA.
Int J Cardiol Heart Vasc. 2018 Mar 8;18:52-57. doi: 10.1016/j.ijcha.2018.02.005. eCollection 2018 Mar.
Dilated Cardiomyopathy (DCM) has been classically considered a progressive disease of the heart muscle that inexorably progresses towards refractory heart failure, ventricular arrhythmias and heart transplant. However, the prognosis of DCM has significantly improved in the past few years, mostly as the result of successful therapy-induced reverse remodeling. Reverse remodeling is a complex process that involves not only the left ventricle, but also many other cardiac structures and it is now recognized both as a measure of therapeutic effectiveness and as an important prognostic tool. Nevertheless, several aspects of reverse remodeling remain unclear, including the best timing for its quantification, its predictors and its interaction with individual genetic backgrounds. In this review, we summarize our current understanding of reverse remodeling in patients with DCM and provide practical recommendations for the clinical management of this challenging patient population.
扩张型心肌病（DCM）传统上被认为是一种心肌进行性疾病，会不可避免地发展为难治性心力衰竭、室性心律失常和心脏移植。然而，在过去几年中，DCM的预后有了显著改善，这主要得益于成功的治疗诱导的逆向重构。逆向重构是一个复杂的过程，不仅涉及左心室，还涉及许多其他心脏结构，现在它既被视为治疗效果的一种衡量指标，也被视为一种重要的预后工具。然而，逆向重构的几个方面仍不清楚，包括其量化的最佳时机、预测因素以及它与个体遗传背景的相互作用。在这篇综述中，我们总结了目前对DCM患者逆向重构的认识，并为这一具有挑战性的患者群体的临床管理提供实用建议。
