Rationale | Non-ischemic cardiomyopathy (NICM) is a subset of cardiomyopathy resulting in ventricular dysfunction and heart failure in the absence of significant ischemic disease (e.g., myocardial infarction). NICM is a heterogenous disease, and risk-stratification based on left ventricular function alone has been inadequate. NICM has a strong genetic component with well-established pathogenic genetic variants in proteins such as TTN. Major advancements in genetic testing have recently revealed the shared genetic underpinnings between NICM and other cardiac diseases, particularly atrial fibrillation (AF). However, the evidence for the implementation of genetic and molecular-based risk prediction and stratification in NICM patients remains lacking.
Question | Can we develop novel and imrpoved risk scores to predict and risk stratify NICM using clinical, genetic, and proteomics data?
Purpose & Objectives | To improve prediction of NICM and risk stratification of NICM patients, using clinical, genetic, and proteomic risk scores. This would include relevant risk factors and outcomes prevalent in the NICM population, including atrial fibrillation (AF) and stroke, arrhythmia, cardiac arrest, and pacemaker or implantable cardioverter-defibrillator (ICD) procedures, as well as response to potentially cardiotoxic therapies (e.g., chemotherapies). Using a combined approach which integrates clinical, genetic, and proteomic biomarkers, we believe that prediction of NICM before clinical manifestation, risk stratification of patients with NICM as baseline, and identification of NICM patients at increased risk of cardiotoxicity in response to drug treatments, could be significantly improved. This would include examining the molecular biomarkers that would predict major risk factors for NICM, such as atrial fibrillation (AF), and the biomarkers which would help risk stratify patients with NICM for relevant outcomes or sequalae such as heart failure and AF.