dc.contributor.author | Escobar López, Luis | |
dc.contributor.author | Ochoa, Juan Pablo | |
dc.contributor.author | García Pavía, Pablo | |
dc.date.accessioned | 2022-01-12T11:44:27Z | |
dc.date.available | 2022-01-12T11:44:27Z | |
dc.date.issued | 2021 | |
dc.identifier.issn | 0735-1097 | spa |
dc.identifier.uri | http://hdl.handle.net/10641/2645 | |
dc.description.abstract | Background
The clinical relevance of genetic variants in nonischemic dilated cardiomyopathy (DCM) is unsettled.
Objectives
The study sought to assess the prognostic impact of disease-causing genetic variants in DCM.
Methods
Baseline and longitudinal clinical data from 1,005 genotyped DCM probands were retrospectively collected at 20 centers. A total of 372 (37%) patients had pathogenic or likely pathogenic variants (genotype positive) and 633 (63%) were genotype negative. The primary endpoint was a composite of major adverse cardiovascular events. Secondary endpoints were end-stage heart failure (ESHF), malignant ventricular arrhythmia (MVA), and left ventricular reverse remodeling (LVRR).
Results
After a median follow-up of 4.04 years (interquartile range: 1.70-7.50 years), the primary endpoint had occurred in 118 (31.7%) patients in the genotype-positive group and in 125 (19.8%) patients in the genotype-negative group (hazard ratio [HR]: 1.51; 95% confidence interval [CI]: 1.17-1.94; P = 0.001). ESHF occurred in 60 (16.1%) genotype-positive patients and in 55 (8.7%) genotype-negative patients (HR: 1.67; 95% CI: 1.16-2.41; P = 0.006). MVA occurred in 73 (19.6%) genotype-positive patients and in 77 (12.2%) genotype-negative patients (HR: 1.50; 95% CI: 1.09-2.07; P = 0.013). LVRR occurred in 39.6% in the genotype-positive group and in 46.2% in the genotype-negative group (P = 0.047). Among individuals with baseline left ventricular ejection fraction ≤35%, genotype-positive patients exhibited more major adverse cardiovascular events, ESHF, and MVA than their genotype-negative peers (all P < 0.02). LVRR and clinical outcomes varied depending on the underlying affected gene.
Conclusions
In this study, DCM patients with pathogenic or likely pathogenic variants had worse prognosis than genotype-negative individuals. Clinical course differed depending on the underlying affected gene. | spa |
dc.language.iso | eng | spa |
dc.publisher | Journal of the American College of Cardiology | spa |
dc.rights | Atribución-NoComercial-SinDerivadas 3.0 España | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/es/ | * |
dc.subject | Dilated cardiomyopathy | spa |
dc.subject | Genetics | spa |
dc.subject | Heart failure | spa |
dc.subject | Left ventricular reverse remodeling | spa |
dc.subject | Mutation | spa |
dc.subject | Prognosis | spa |
dc.subject | Sudden cardiac death | spa |
dc.subject | Ventricular arrhythmia | spa |
dc.title | Association of Genetic Variants With Outcomes in Patients With Nonischemic Dilated Cardiomyopathy. | spa |
dc.type | journal article | spa |
dc.type.hasVersion | SMUR | spa |
dc.rights.accessRights | open access | spa |
dc.description.extent | 230 KB | spa |
dc.identifier.doi | 10.1016/j.jacc.2021.08.039 | spa |
dc.relation.publisherversion | https://www.sciencedirect.com/science/article/abs/pii/S0735109721060861?via%3Dihub | spa |