Maintaining Success for Patients With Dilated Cardiomyopathy and Remission of Heart Failure

Remission of heart failure, defined by resolution of symptoms, normalization of left ventricular ejection fraction, and plasma concentrations of natriuretic peptides and by the ability to withdraw diuretic agents without recurrence of congestion is increasingly recognized among patients with dilated cardiomyopathy. Once remission has been achieved, it is unclear which treatments need to be continued long term. The durability of remission and likelihood of relapse are likely to be determined by intrinsic myocardial susceptibility, the persistence or recurrence of any acquired triggers, and current and future myocardial workload. Each of these should be addressed to enable personalized therapy to delay or prevent relapse. Management should be informed by evidence from randomized trials of targeted therapeutic strategies.