Diagnostic yield and therapeutic consequences of additional testing in ‘idiopathic’ dilated cardiomyopathy
| Diagnostic test | Diagnostic yield | Therapeutic consequences |
|---|---|---|
| Cardiac MRI | Two patients diagnosed with non-compaction cardiomyopathy | Oral anticoagulation initiated and ICDs implanted |
| MRI with gadolinium contrast | Two patients diagnosed with cardiomyopathy in association with systemic inflammatory disease | Appropriate immunosuppressant therapy initiated |
| Right-sided cardiac catheterisation | None | No direct therapeutic consequences. Haemodynamic data can be used to optimise diuretic treatment |
| Endomyocardial biopsy | Two patients diagnosed with cardiac sarcoidosis* and ATTR-amyloidosis, respectively | Patient with sarcoidosis treated with prednisone |
| Exercise test with measurement of peak oxygen consumption | None | Ventricular arrhythmia prompted ICD implantation in two patients. Peak oxygen consumption one of several parameters used in stratification for heart transplantation |
| Twenty-four-hour ECG | None | No direct consequences. Detection of non-sustained ventricular tachycardia strengthens the case for ICD implantation |
| Genetic screening | Ten patients diagnosed with possible disease-causing mutations | Finding prompted ICD implantation in one patient. Allowed for family screening |
*This patient was also diagnosed on cardiac MRI with late gadolinium enhancement.
ICD, implantable cardioverter-defibrillator.