Prognosis of heart failure in idiopathic dilated cardiomyopathy: has it improved in tertiary referral centres over the last 10 years?

doi:10.1016/j.ehj.2004.05.031 Prognosis of heart failure in idiopathic dilated cardiomyopathy: has it improved in tertiary referral centres over the last 10 years? We read with great interest the recent article of Schaufelberger et al.1 about improvement of the prognosis of heart failure between 1988 and 2000 in Swe-den. Current medical and non-medical therapies (such as the use of ACE-inhibi-tors and beta-blockers, more frequent use of implantable cardioverter defibril-lators, and bi-ventricular pacing have improved the overall prognosis in heart failure whatever the aetiology. Treatment of myocardial infarction has had major changes during this period. In contrast, it is unclear whether prognosis was really improved in the particular set-ting of patients with idiopathic dilated car-diomyopathy (IDC) seen in the tertiary referral centers. Despite the improvement of the medical strategy in heart failure and its recognised efficacy, the prognosis of patients with well characterised IDC seemed unchanged in centres similar to our institution in the recent years. The recruitment of more severe patients (lar-ger left ventricular diameters, lower left ventricular ejection fraction and/or higher filling pressures) that might be candidate to some non-medical therapies may thus induce a selection bias in these centres