International Journal of Research in Medical Sciences | December 2022 | Vol 10 | Issue 12 Page 1 International Journal of Research in Medical Sciences Panda S et al. Int J Res Med Sci. 2022 Dec;10(12):xxx-xxx www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Clinical dimensions of hypokinetic non-dilated cardiomyopathy in terms of severity and hospital outcome Sibaram Panda 1 *, Sunil K. Sharma 1 , Mayadhar Panda 2 INTRODUCTION Dilated cardiomyopathy (DCM) is the commonest prototype of cardiomyopathy in which systolic dysfunction is typically associated with LV dilatation. However, there is a subtype of DCM that does not meet the standard criteria of LV dilatation in spite of global LV systolic dysfunction. About three decades ago, for the first time Andre Keren presented an excellent insight about the subtype of DCM while studying end stage heart failure patients. 1 Unfortunately the study didn’t get the recognition as it deserve. But gradually over a period of time, numerous studies have been attempted to emphasize the same subtype to evaluate clinical dimension, however uniformity has not been maintained among them while defining the disease subtype due to use of different terminologies, inclusion criteria and cut off values for EF, LVEDD. 1-6 Therefore for early diagnosis and prevention of progression of the disease subtype, in 2016 European society of cardiology (ESC) proposed a new terminology HNDC [DCM (ND-H)],which is defined as left ventricular or biventricular global dysfunction (EF<45%) without dilation not explained by abnormal loading condition or CAD. 7 Prevalence of patients with HNDC is 0.9-1.9% among population as per a recent study. 8 As newer studies completely based on ESC criteria are very few in number 1 Department of Cardiology, VIMSAR, Burla, Odisha, India 2 Department of Community Medicine, SJMC, Puri, Odisha, India Received: 20 October 2022 Accepted: 04 November 2022 *Correspondence: Dr. Sibaram Panda, E-mail: drsibaram@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Hypokinetic non-dilated cardiomyopathy [HNDC/DCM (ND-H)] is a recently proposed (by ESC, 2016) subtype of dilated cardiomyopathy (DCM), which is characterized by the absence of left ventricular (LV) dilatation despite of global LV systolic dysfunction. Knowledge regarding clinical severity and outcomes of patients with DCM (ND-H) is very limited. Objective of the study was to evaluate clinical severity and hospital outcome of patients with HNDC [DCM (ND-H)]. Methods: Total 1248 admitted patients with primary DCM were finalized as study participants considering inclusion and exclusion criteria. The study participants were categorized into two groups depending on presence or absence of LV dilatation. 411 (32.9%) patients without any LV dilatation included in group A [HNDC/DCM (ND-H) group] and 837 (67.1%) patients with LV dilatation included in group B [DCM (D-H) group]. Data with respect to clinical, electrocardiographic, echocardiographic findings and disease outcome of patients compared statistically between the two groups. Conclusions: HNDC [DCM (ND-H)] is a subclinical subtype, which represents 1/3rd population of DCM. Apart from absence of cardiomegaly, typical clinical signs, electrocardiographic abnormalities, from which we can suspect heart disease, were less prevalent in patients with DCM (ND-H). Therefore, patient most often miss the diagnosis till the advance stage. Non cardiac co-morbidities along with late diagnosis can be important contributing factors for adverse clinical outcomes in patients with DCM (ND-H) comparable to the DCM (D-H) counterpart. Keywords: DCM, DCM (ND-H), DCM (D-H), MR, S3 DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222988