Next Article in Journal / Special Issue
Midkine’s Role in Cardiac Pathology
Previous Article in Journal / Special Issue
Diagnostic Yield of Whole Exome Sequencing in Pediatric Dilated Cardiomyopathy
Article Menu

Export Article

Open AccessArticle
J. Cardiovasc. Dev. Dis. 2017, 4(3), 12;

Insights from Second-Line Treatments for Idiopathic Dilated Cardiomyopathy

Department of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy
Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
Author to whom correspondence should be addressed.
Received: 30 June 2017 / Revised: 18 August 2017 / Accepted: 19 August 2017 / Published: 23 August 2017
(This article belongs to the Special Issue Genetics and Treatment of Dilated Cardiomyopathy)
Full-Text   |   PDF [1568 KB, uploaded 23 August 2017]   |  


Background: Dilated cardiomyopathy (DCM) is an independent nosographic entity characterized by left ventricular dilatation and contractile dysfunction leading to heart failure (HF). The idiopathic form of DCM (iDCM) occurs in the absence of coronaropathy or other known causes of DCM. Despite being different from other forms of HF for demographic, clinical, and prognostic features, its current pharmacological treatment does not significantly diverge. Methods: In this study we performed a Pubmed library search for placebo-controlled clinical investigations and a post-hoc analysis recruiting iDCM from 1985 to 2016. We searched for second-line pharmacologic treatments to reconsider drugs for iDCM management and pinpoint pathological mechanisms. Results: We found 33 clinical studies recruiting a total of 3392 patients of various durations and sizes, as well as studies that tested different drug classes (statins, pentoxifylline, inotropes). A metanalysis was unfeasible, although a statistical significance for changes upon treatment for molecular results, morphofunctional parameters, and clinical endpoints was reported. Statins appeared to be beneficial in light of their pleiotropic effects; inotropes might be tolerated more for longer times in iDCM compared to ischemic patients. General anti-inflammatory therapies do not significantly improve outcomes. Metabolic and growth modulation remain appealing fields to be investigated. Conclusions: The evaluation of drug effectiveness based on direct clinical benefit is an inductive method providing evidence-based insights. This backward approach sheds light on putative and underestimated pathologic mechanisms and thus therapeutic targets for iDCM management. View Full-Text
Keywords: idiopathic dilated cardiomyopathy; clinical trials; drug repurposing idiopathic dilated cardiomyopathy; clinical trials; drug repurposing

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Luciani, M.; Del Monte, F. Insights from Second-Line Treatments for Idiopathic Dilated Cardiomyopathy. J. Cardiovasc. Dev. Dis. 2017, 4, 12.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
J. Cardiovasc. Dev. Dis. EISSN 2308-3425 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top