{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:53:21Z","timestamp":1790621601682,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2013,12,14]],"date-time":"2013-12-14T00:00:00Z","timestamp":1386979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>ACE-inhibitors, \u03b2-blockers, implantable cardioverter\u2013defibrillator (ICD) and cardiac resynchronization therapy (CRT) improved prognosis of heart failure. We sought to analyse the long-term prognostic impact of evidence-based integrated therapeutic strategies in patients with idiopathic dilated cardiomyopathy (IDCM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>From 1978 to 2007, 853 IDCM patients (45\u2009\u00b1\u200915\u2009years, 72% males) were enrolled and classified as follows: Group 1, 110 patients (12.8%) enrolled during 1978\u20131987; Group 2, 376 patients (44.1%) enrolled during 1988\u20131997; Group 3, 367 patients (43.1%) enrolled during 1998\u20132007. ACE-inhibitors\/angiotensin receptor blockers were administered in 34%, 93%, and 93% (P\u2009&amp;lt;0.001), and \u03b2-blockers in 11%, 82%, and 86% (P\u2009&amp;lt;0.001) in Groups 1, 2, and 3, respectively; ICDs were implanted in 2%, 14%, and 13% (P\u2009=\u20090.005); mean time to device implantation was lower in Group 3. At 8\u2009years, heart transplant (HTx)-free survival rates were 55%, 71%, and 87% in Groups 1, 2, and 3, respectively (P\u2009&amp;lt;0.001). Similar progressive improvement was found for pump-failure death (DHF)\/HTx, while survival free from sudden death (SD) was significantly improved only in Group 3. Multivariable models considering competing risk indicated early diagnosis (i.e. a baseline less advanced disease stage) and tailored medical therapy (HR 0.44, CI 95% 0.19\u20130.98) as independent protectors against DHF\/HTx. Concerning SD, lower left ventricular ejection fraction emerged as a predictor, while ICD was the only therapy with a protective role (HR 0.08, CI 95% 0.01\u20130.61). Treatment with digitalis emerged as a predictor of both DHF\/HTx and SD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An effective management and evidence-based integrated therapeutic approach progressively and significantly improved the long-term prognosis of IDCM during the last three decades.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.16","type":"journal-article","created":{"date-parts":[[2014,3,3]],"date-time":"2014-03-03T06:56:35Z","timestamp":1393829795000},"page":"317-324","source":"Crossref","is-referenced-by-count":196,"title":["Long-Term Prognostic Impact of Therapeutic Strategies in Patients with Idiopathic Dilated Cardiomyopathy: Changing Mortality over the Last 30\u2009Years"],"prefix":"10.1093","volume":"16","author":[{"given":"Marco","family":"Merlo","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Pivetta","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Pinamonti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Zecchin","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Barbati","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Di Lenarda","sequence":"additional","affiliation":[{"name":"Cardiovascular Centre, Azienda per i Servizi Sanitari (A.S.S.) n 1 , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Ospedali Riuniti and University of Trieste , Trieste, 34149 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,12,14]]},"reference":[{"key":"2026011921112089100_ejhf16-bib-0001","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/S0735-1097(97)00433-6","article-title":"Familial dilated cardiomyopathy: cardiac abnormalities are common in asymptomatic relatives and may represent early disease","volume":"31","author":"Baig","year":"1998","journal-title":"J Am Coll Cardiol"},{"key":"2026011921112089100_ejhf16-bib-0002","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S0735-1097(99)00172-2","article-title":"Familial dilated cardiomyopathy: evidence for genetic and phenotypic heterogeneity. 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