Aetiological Characterisation Sample Clauses

Aetiological Characterisation. DCM represents a unique family of diseases whose clinical manifestations can further be characterised by its aetiological heterogeneity, as influenced by the genetic or non-genetic causes, and sometimes the interactions between them (Figure 2-2). In this way, DCM represents the final pathway of different pathological processes and identifying the underlying cause could have prognostic value in the subsequent management (75). Due to improved outcomes for many individuals, clinical characteristics over the long term may evolve. In theory, concomitant comorbidities excluded as contributors to the phenotype at presentation may compete with and aggravate the clinical status over time. These potentially can influence LV morphology if poorly managed. An example of this is uncontrolled hypertension, which is often excluded at recruitment in many registries, as the paradigm of hypertensive heart disease includes those who transition to LV dilatation and systolic impairment. DCM patients are thought to have a higher prevalence of hypertension compared to age-matched controls in the population, and over time from registry data, its presence has thus far not been shown to influence adverse outcomes (58,76–78). This may be partly due to their responsiveness to medical therapy such as ACE-inhibitors and or beta blockers that also have antihypertensive properties (78). DCM is characterised by acquired factors, presumed to be often reversible in the context of “idiopathic” DCM or can contribute to clinical expression or progression in those with an underlying genetic substrate.