{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:38:49Z","timestamp":1790217529903,"version":"4.1.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T00:00:00Z","timestamp":1478217600000},"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":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Mildly dilated cardiomyopathy (MDCM) has been proposed as a subtype of dilated cardiomyopathy (DCM) characterized by systolic dysfunction in the absence of significant LV dilatation. Few data on the characteristics and outcomes of MDCM patients are available. We sought to assess the main features and the long-term natural history of MDCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>From 1988 to 2010 we analysed all DCM patients consecutively evaluated at our Institution. MDCM was defined as LVEF &amp;lt;45% and LV end-diastolic volume index (LVEDVI) \u226470 mL\/m2 in women and \u226489 mL\/m2 in men. Among a total population of 638 patients, 226 (35%) fulfilled the criteria for MDCM. Compared with the other patients, they presented features of a less advanced disease and an overall long-term lower rate of all-cause mortality\/heart transplantation (D\/HTx; total events\u2009=\u2009209; 144 deaths, 65 HTx): D\/HTx at 10 years 15% in MDCM vs. 30% in DCM (P &amp;lt; 0.001). However, throughout the follow-up, 55 MDCM patients (24%) evolved to DCM by increasing LVEDVI, consistently worsening their long-term prognosis. Among persistent MDCM patients, a restrictive filling pattern [hazard ratio (HR) 5.30; 95% confidence interval (CI) 2.34\u201312.01, P &amp;lt; 0.001] and non-sustained ventricular tachycardia (HR 2.21; 95% CI 1.003\u20135.11, P = 0.047), but not LVEF, were independently associated with D\/HTx at multivariate analysis [time-dependent receiver operating characteristic (ROC) curve: area under the curve (AUC) 0.80, 95% CI 0.65\u20130.94, P = 0.003].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MDCM identifies a consistent subgroup of DCMs diagnosed in an earlier stage and presenting an apparent better evolution. However, some MDCMs evolve into DCM despite medical therapy, whereas persistent MDCMs with non-sustained ventricular arrhythmias and restrictive filling pattern are characterized by a very poor outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.608","type":"journal-article","created":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T04:04:39Z","timestamp":1478232279000},"page":"531-539","source":"Crossref","is-referenced-by-count":43,"title":["Insights into Mildly Dilated Cardiomyopathy: Temporal Evolution and Long-Term Prognosis"],"prefix":"10.1093","volume":"19","author":[{"given":"Marta","family":"Gigli","sequence":"first","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stolfo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Merlo","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Barbati","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Ramani","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Brun","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Pinamonti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Sinagra","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, \u2018Ospedali Riuniti\u2019 and University of Trieste , Trieste ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,11,4]]},"reference":[{"key":"2026011721181362300_ejhf608-bib-0001","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1093\/eurheartj\/ehm342","article-title":"Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"29","author":"Elliott","year":"2008","journal-title":"Eur Heart J"},{"key":"2026011721181362300_ejhf608-bib-0002","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/ejhf.16","article-title":"Long-term prognostic impact of therapeutic strategies in patients with idiopathic dilated cardiomyopathy: changing mortality over the last 30 years","volume":"16","author":"Merlo","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"2026011721181362300_ejhf608-bib-0003","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1161\/CIRCULATIONAHA.111.070235","article-title":"Advances in the epidemiology of heart failure and left ventricular remodeling","volume":"124","author":"Cheng","year":"2011","journal-title":"Circulation"},{"key":"2026011721181362300_ejhf608-bib-0004","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1093\/eurheartj\/ehv727","article-title":"Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: a position statement of the ESC working group on myocardial and pericardial diseases","volume":"37","author":"Pinto","year":"2016","journal-title":"Eur Heart J"},{"key":"2026011721181362300_ejhf608-bib-0005","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1161\/01.CIR.72.2.302","article-title":"Mildly dilated congestive cardiomyopathy","volume":"72","author":"Keren","year":"1985","journal-title":"Circulation"},{"key":"2026011721181362300_ejhf608-bib-0006","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1161\/01.CIR.81.2.506","article-title":"Mildly dilated congestive cardiomyopathy. Use of prospective diagnostic criteria and description of the clinical course without heart transplantation","volume":"81","author":"Keren","year":"1990","journal-title":"Circulation"},{"key":"2026011721181362300_ejhf608-bib-0007","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/0002-8703(93)90020-A","article-title":"The spectrum of left ventricular size in dilated cardiomyopathy: clinical correlates and prognostic implications. SPIC (Italian Multicenter Cardiomyopathy Study) Group","volume":"125","author":"Gavazzi","year":"1993","journal-title":"Am Heart J"},{"key":"2026011721181362300_ejhf608-bib-0008","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.amjcard.2009.10.068","article-title":"Prevalence and clinical characteristics of nondilated cardiomyopathy and the effect of atrial fibrillation","volume":"105","author":"Doumas","year":"2010","journal-title":"Am J Cardiol"},{"key":"2026011721181362300_ejhf608-bib-0009","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/01.CIR.93.5.841","article-title":"Report of the 1995 World Health Organization\/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies","volume":"93","author":"Richardson","year":"1996","journal-title":"Circulation"},{"key":"2026011721181362300_ejhf608-bib-0010","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1053\/euhj.1998.1145","article-title":"Guidelines for the study of familial dilated cardiomyopathies. Collaborative Research Group of the European Human and Capital Mobility Project on Familial Dilated Cardiomyopathy","volume":"20","author":"Mestroni","year":"1999","journal-title":"Eur Heart J"},{"key":"2026011721181362300_ejhf608-bib-0011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"2026011721181362300_ejhf608-bib-0012","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/eurjhf\/hfs105","article-title":"ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC","volume":"14","author":"McMurray","year":"2012","journal-title":"Eur J Heart Fail"},{"key":"2026011721181362300_ejhf608-bib-0013","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1093\/ejechocard\/jep007","article-title":"Recommandations for the evaluation of left ventricular diastolic function by echocardiography","volume":"10","author":"Nagueh","year":"2009","journal-title":"Eur J Echocardiogr"},{"key":"2026011721181362300_ejhf608-bib-0014","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/ehjci\/jet105","article-title":"Scientific Document Committee of the European Association of Cardiovascular Imaging. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging","volume":"14","author":"Lancellotti","year":"2013","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026011721181362300_ejhf608-bib-0015","volume-title":"Generalized, Linear, and Mixed Models","author":"McCulloch","year":"2008","edition":"2nd ed"},{"key":"2026011721181362300_ejhf608-bib-0016","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1253\/circj.66.557","article-title":"Long-term prognosis of patients with mildly dilated cardiomyopathy","volume":"66","author":"Kitaoka","year":"2002","journal-title":"Circ J"},{"key":"2026011721181362300_ejhf608-bib-0017","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1093\/eurjhf\/hfq093","article-title":"Prognostic impact of familial screening in dilated cardiomyopathy","volume":"12","author":"Moretti","year":"2010","journal-title":"Eur J Heart Fail"},{"key":"2026011721181362300_ejhf608-bib-0018","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1016\/j.jacc.2010.11.030","article-title":"Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment","volume":"57","author":"Merlo","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026011721181362300_ejhf608-bib-0019","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.jacc.2011.08.078","article-title":"Risk factors for malignant ventricular arrhythmias in lamin a\/c mutation carriers a European cohort study","volume":"59","author":"van Rijsingen","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2026011721181362300_ejhf608-bib-0020","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.ejheart.2005.11.003","article-title":"Desmin accumulation restrictive cardiomyopathy and atrioventricular block associated with desmin gene defect","volume":"8","author":"Arbustini","year":"2006","journal-title":"Eur J Heart Fail"},{"key":"2026011721181362300_ejhf608-bib-0021","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1161\/CIRCULATIONAHA.106.646778","article-title":"Familial Cardiomyopathy Registry; prevalence of desmin mutations in dilated cardiomyopathy","volume":"115","author":"Taylor","year":"2007","journal-title":"Circulation"},{"key":"2026011721181362300_ejhf608-bib-0022","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.advms.2015.01.009","article-title":"Changes in desmin expression in patients with cardiac diastolic dysfunction and preserved or reduced ejection fraction","volume":"60","author":"Pawlak","year":"2015","journal-title":"Adv Med Sci"},{"key":"2026011721181362300_ejhf608-bib-0023","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1093\/eurheartj\/ehs397","article-title":"Diagnostic work-up in cardiomyopathies: bridging the gap between clinical phenotypes and final diagnosis. A position statement from the ESC Working Group on Myocardial and Pericardial Diseases","volume":"34","author":"Rapezzi","year":"2013","journal-title":"Eur Heart J"},{"key":"2026011721181362300_ejhf608-bib-0024","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.echo.2008.02.006","article-title":"Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study","volume":"21","author":"Pettersen","year":"2008","journal-title":"J Am Soc Echocardiogr"}],"container-title":["European Journal of Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejhf.608","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejhf.608","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/19\/4\/531\/66330393\/eurjhf_19_4_531.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjhf\/article-pdf\/19\/4\/531\/66330393\/eurjhf_19_4_531.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:19:34Z","timestamp":1768702774000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjhf\/article\/19\/4\/531\/8418774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,4]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2016,11,4]]},"published-print":{"date-parts":[[2017,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ejhf.608","relation":{},"ISSN":["1388-9842","1879-0844"],"issn-type":[{"value":"1388-9842","type":"print"},{"value":"1879-0844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,4]]},"published":{"date-parts":[[2016,11,4]]}}}