Cardiothoracovascular Department , Center for Diagnosis and Management of Cardiomyopathies, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste.
Cardiology Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Hospital of Gorizia and Monfalcone.
J Cardiovasc Med (Hagerstown). 2020 Dec;21(12):927-943. doi: 10.2459/JCM.0000000000001050.
: Nonischemic-dilated cardiomyopathy (NIDCM) is an entity that gathers extremely heterogeneous diseases. This awareness, although leading to continuous improvement in survival, has increased the complexity of NIDCM patients' management. Even though the endorsed 'red-flags' approach helps clinicians in pursuing an accurate etiological definition in clinical practice, it is not clear when and how peripheral centers should interact with referral centers with specific expertise in challenging scenarios (e.g. postmyocarditis and genetically determined dilated cardiomyopathy) and with easier access to second-line diagnostic tools and therapies. This position paper will summarize each step in NIDCM management, highlighting the multiple interactions between peripheral and referral centers, from first-line diagnostic workup and therapy to advanced heart failure management and long-term follow-up.
非缺血性扩张型心肌病（NIDCM）是一种包含多种极度异质性疾病的病症。尽管这种认识导致了生存的持续改善，但也增加了 NIDCM 患者管理的复杂性。尽管公认的“红旗”方法有助于临床医生在临床实践中对准确的病因定义进行研究，但目前尚不清楚何时以及如何让基层中心与具有特定专业知识的转诊中心进行互动，这些中心在处理具有挑战性的情况（例如心肌炎后和遗传性扩张型心肌病）时以及在获得二线诊断工具和治疗方面具有更便捷的途径。本立场文件将总结 NIDCM 管理的每个步骤，突出基层和转诊中心之间的多重相互作用，从一线诊断和治疗到晚期心力衰竭管理和长期随访。
