{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:48:55Z","timestamp":1760647735432,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: The 2019 coronavirus pandemic (COVID-19) represented a significant challenge for the medical community. The first aim of this study was to examine the COVID-19 impact on the follow-up of patients with dilated cardiomyopathy (DCM) and to establish the advantages of multiparametric home monitoring. Also, we tried to establish the main prognostic predictors at 2-years follow-up and the value of LV diastolic filling pattern (LVDFP) in increasing mortality and morbidity. Materials and Methods: We conducted a prospective study of 142 patients with DCM assessed by in-patient visit in the pre-pandemic period and hybrid (face-to-face, online consultation and telemedicine home monitoring with a dedicated application) during the pandemic period. The statistical analysis compared the strategy used in the pre-pandemic with management during the pandemic, in terms of clinical assessment, hospitalizations\/emergency room visits due to HF exacerbation and total mortality. Results: We did not observe significant changes in blood pressure (BP), heart rate (FC), weight and symptoms or an increased rate of adverse drug events between the two periods. We successfully titrated HF medications with close monitoring of HF decompensations, which were similar in number, but were mostly managed at home during the pandemic. There was also no statistically significant difference in emergency room visits due to severe decompensated HF. Mortality in the first and second year of follow-up was between 12.0 and 13%, similar in the pre-pandemic and pandemic periods, but significantly higher in patients with restrictive LVDFP. Clinical improvement or stability after 2 years was more frequent in patients with nonrestrictive LVDFP. The main prognostic predictors at 1 and 2-years follow-up were: the restrictive LVDFP, significantly dilated LV, comorbidities (DM, COPD), older age, associated severe mitral regurgitation and pulmonary hypertension. Conclusions: The pandemic restrictions determined a marked decrease of the healthcare use, but no significant change in the clinical status of DCM patients under multiparametric home monitoring. At 2-years follow-up, the presence of the restrictive LVDFP was associated with an increased risk of death and with a worse clinical status in DCM patients.<\/jats:p>","DOI":"10.3390\/jcm11247411","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T03:01:51Z","timestamp":1671073311000},"page":"7411","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Challenges for Management of Dilated Cardiomyopathy during COVID-19 Pandemic\u2014A Telemedicine Application"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1439-5002","authenticated-orcid":false,"given":"Luminita","family":"Iliuta","sequence":"first","affiliation":[{"name":"Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"},{"name":"Cardioclass Clinic for Cardiovascular Disease, 031125 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5590-7879","authenticated-orcid":false,"given":"Andreea Gabriella","family":"Andronesi","sequence":"additional","affiliation":[{"name":"Nephrology Department, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"},{"name":"Nephrology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0083-8992","authenticated-orcid":false,"given":"Eugenia","family":"Panaitescu","sequence":"additional","affiliation":[{"name":"Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madalina Elena","family":"Rac-Albu","sequence":"additional","affiliation":[{"name":"Medical Informatics and Biostatistics Department, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Scafa-Udri\u0219te","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"},{"name":"Department of Cardiology, Clinical Emergency Hospital, 014461, Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hora\u021biu","family":"Moldovan","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Pathology, University of Medicine and Pharmacy \u201cCarol Davila\u201d, 050474 Bucharest, Romania"},{"name":"Department of Cardiovascular Surgery, Clinical Emergency Hospital, 014461 Bucharest, Romania"},{"name":"Academy of Romanian Scientists (AOSR), 3 Ilfov Street, 050044 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jchf.2020.01.014","article-title":"Advanced Heart Failure: Epidemiology, Diagnosis, and Therapeutic Approaches","volume":"8","author":"Truby","year":"2020","journal-title":"JACC Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/s41572-019-0084-1","article-title":"Dilated cardiomyopathy","volume":"5","author":"Schultheiss","year":"2019","journal-title":"Nat. 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