Dilated cardiomyopathy: a pharmacotherapeutic research
Keywords:Community awareness programs, Dilated cardiomyopathy, Prevalence, Prognosis, Treatment pattern, Ventricular hypertrophy
Background: AHA defines cardiomyopathies as a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilatation and are due to a variety of causes that frequently are genetic.
Methods: This is a prospective observational study conducted in the year 2017 at an OPD of Cardiology of a private hospital located in Telangana state, India. Data has been collected after diagnosis is made and treatment regimen is given by an Interventional Cardiologist.
Results: Data has been collected from 78 cardiac patients, out of which 17.9% patients had Dilated Cardiomyopathy (DCM) among them 57.14% were male. In the present study DCM was reported more in the age group of 61-70 years (42.85%). Treatment pattern in most of the prescriptions include Diuretics, Beta blockers, Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs), Cardiac Glycosides, Antiplatelet and Antihyperlipidaemics.
Conclusions: To conclude, lack of awareness among people about this disease is leading it to progress to advanced stages and prognosis of which is poor. Conducting community awareness programs can play a key component in improving the prognosis of this disease.
Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br Heart J 1980;44:672-3.
Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O’Connell J, et al. Report of the 1995 World Health Organization/ International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93:841-2.
Bozkurt B, Colvin M, Cook J, Cooper LT, Deswal A, Fonarow GC, et al. American Heart Association Committee on Heart Failure and Transplantation of the Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; and Council on Quality of Care and Outcomes Research. Current diagnostic and treatment strategies for specific dilated cardiomyopathies: a scientific statement from the American Heart Association. Circulation. 2016 Dec 6;134(23):e579-646.
Hamayak S. Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies. World J Cardiol. 2014 June 26;6(6):478-94.
Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, et al. Classification of the cardiomyopathies:a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270-6.
Demakis JG, Proskey A, Rahimtoola SH, Jamil M, Sutton GC, Rosen KM, et al. The natural course of alcoholic cardiomyopathy. Ann Intern Med. 1974;80:293-7.
Guillo P, Mansourati J, Maheu B, Etienne Y, Provost K, Simon O, et al. Long-term prognosis in patients with alcoholic cardiomyopathy and severe heart failure after total abstinence. Am J Cardiol. 1997;79:1276-8.
Marcus FI, McKenna WJ, Sherrill D, Basso C, Bauce B, Bluemke DA, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/ dysplasia: proposed modification of the Task Force Criteria. Eur Heart J. 2010;31:806-14.
Falase AO, Ogah OS. Cardiomyopathies and myocardial disorders in Africa: present status and the way forward. Cardiovasc J Afr. 2012;23:552-62.
Bharath DK, Chandrashekhar R, Manohar VR, Rai M, Gopalakrishna HN, Dsouza R. Drug Utilization study in patients with congestive cardiac failure in a South Indian tertiary care hospital: A retrospective study. Int Res J Pharm. 2015;6:463-6.
Baskota M, Rao BS, Shakya R. Study on the prescribing patterns of drugs used in heart failure. Kathmandu Unive J Scie Eng Technol. 2006;2:1-10.
Towbin JA, Lowe AM, Colan SD, Sleeper LA, Orav EJ, Clunie S, et al. Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA. 2006;296:1867-76.
Banerjee P, Mandal A, Mukhopadhyay D, Gangopadhyay T, Mandal S, Das A. Assessment of drug utilization pattern and rationality of drug use in treatment of dilated cardiomyopathy in a tertiary care teaching hospital of rural Bengal. Int J Basic Clin Pharmacol. 2017;6:123-7.
Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. Writing Committee M. 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults. Circulation. 2009;119:e391-e479.
Kurtoglu E, Balta S, Karakus Y, Yasar E, Cuglan B, Kaplan O, et al. Ivabradine Improves Heart Rate Variability in Patients with Nonischemic Dilated Cardiomyopathy. Arquivos Brasileiros de Cardiologia. 2014;103:308-14.
Yeoh T, Hayward C, Benson V, Sheu A, Richmond Z, Feneley MP, et al. A Randomised, Placebo-controlled Trial of Carvedilol in Early Familial Dilated Cardiomyopathy. Heart, Lung and Circulation. 2011;20:566-73.
Schnabel P, Maack C, Mies F, Tyroller S, Scheer A, Böhm M. Binding properties of beta-blockers at recombinant beta1-, beta2-, and beta3-adrenoceptors. J Cardiovasc Pharmacol. 2000;36(4):466-71.
Harting J, Becker KH, Bergmann R, Bourgois R, Enenkel HJ, Fuchs A, et al. Pharmacodynamic profile of the selective beta 1-adrenoceptor antagonist bisoprolol. Arzneimittel-Forschung. 1986 Feb;36(2):200-8.
Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med. 2000;342:145-53.
Busseuil D, Shi Y, Mecteau M, Brand G, Gillis MA, Thorin E, et al. Heart rate reduction by ivabradine reduces diastolic dysfunction and cardiac fibrosis. Cardiology. 2010;117:234-42.
Tardif JC, O'Meara E, Komajda M, Böhm M, Borer JS, Ford I, et al. SHIFT Investigators Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy. Eur Heart J. 2011;32:2507-15.