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Echocardiographic Evaluation in Asymptomatic Relatives of Patients with Dilated Cardiomyopathy Reveals Preclinical Disease

Niall G. Mahon, MD; Ross T. Murphy, MD; Calum A. MacRae, MD; Alida L.P. Caforio, MD; Perry M. Elliott, MD; and William J. McKenna, MD
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From St. George's Hospital Medical School, London, United Kingdom; Massachusetts General Hospital, Charlestown, Massachusetts; and University of Padua, Padua, Italy.

Acknowledgments: The authors gratefully acknowledge the contributions of Phil Keeling, Jonathan Goldman, Kamran Baig, Carol Page, and Mary Gould to this work.

Grant Support: Drs. Mahon, Murphy, and McKenna were supported by the British Heart Foundation, and Dr. Caforio was supported by the Veneto Region Target Project and the Ministero dell'Università e della Ricerca Scientifica e Tecnologica (MURST) Target project.

Potential Financial Conflicts of Interest: Grants pending: C.A. MacRae (National Institutes of Health).

Requests for Single Reprints: William J. McKenna, MD, The Heart Hospital, Westmoreland Street, London W1G 8PH, United Kingdom; e-mail, william.mckenna@uclh.org.

Current Author Addresses: Dr. Mahon: Department of Cardiology, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Ireland.

Drs. Murphy, Elliott, and McKenna: The Heart Hospital, Westmoreland Street, London W1G 8PH, United Kingdom.

Dr. McRae: Cardiovascular Research Center, 149 13th Street, 4th Floor, Charlestown, MA 02129.

Dr. Caforio: Division of Cardiology, Department of Clinical and Experimental Medicine, University of Padua, Policlinico Universitario, Centro V. Gallucci, via N. Giustiniani, 2, 35128 Padova, Italy.

Author Contributions: Conception and design: N.G. Mahon, C.A. MacRae, A.L.P. Caforio, P.M. Elliott, W.J. McKenna.

Analysis and interpretation of the data: N.G. Mahon, P.M. Elliott, W.J. McKenna.

Drafting of the article: N.G. Mahon, R.T. Murphy, W.J. McKenna.

Critical revision of the article for important intellectual content: R.T. Murphy, C.A. MacRae, A.L.P. Caforio.

Final approval of the article: C.A. MacRae, P.M. Elliott, A.L.P. Caforio, W.J. McKenna.

Provision of study materials or patients: N.G. Mahon.

Statistical expertise: N.G. Mahon.

Obtaining of funding: N.G. Mahon, W.J. McKenna.

Administrative, technical, or logistic support: P.M. Elliott, W.J. McKenna.

Collection and assembly of data: N.G. Mahon, R.T. Murphy.

Ann Intern Med. 2005;143(2):108-115. doi:10.7326/0003-4819-143-2-200507190-00009
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The human research committee at St. George's Hospital Medical School, London, United Kingdom, reviewed and approved the entire study protocol. We obtained informed consent from each patient to contact family members and subsequently from each family member who agreed to participate in the study.

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Grahic Jump Location
Figure 1.
Summary of evaluation of relatives of patients with dilated cardiomyopathy.

DCM = dilated cardiomyopathy; DFS = depressed fractional shortening; LVE = left ventricular enlargement. *Enrolled from 370 consecutive patients with dilated cardiomyopathy. †865 relatives who agreed to participate, equaling 78% of the 1109 first- and second-degree relatives. ‡16 of the 140 individuals with LVE/DFS declined follow-up. §Nonrandomized sample of the total 592 initially healthy relatives.

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Figure 2.
Kaplan–Meier survival curve from initial echocardiographic evaluation (time 0) in asymptomatic relatives showing risk for progression to dilated cardiomyopathy on the basis of echocardiographic findings.

LVE/DFS = left ventricular enlargement and depressed fractional shortening.

Grahic Jump Location




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Summary for Patients

How Common Is Silent Heart Disease in the Relatives of Patients with Heart Failure?

The summary below is from the full report titled “Echocardiographic Evaluation in Asymptomatic Relatives of Patients with Dilated Cardiomyopathy Reveals Preclinical Disease.” It is in the 19 July 2005 issue of Annals of Internal Medicine (volume 143, pages 108-115). The authors are N.G. Mahon, R.T. Murphy, C.A. MacRae, A.L.P. Caforio, P.M. Elliott, and W.J. McKenna.


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