Dr. Sanjay Prasad

Dilated cardiomyopathy is a condition in which the wall of the heart gets stretched and thin. Patient outcomes vary but for many the symptoms improve and patients can live normal lives. However, it is unknown whether it is safe to discontinue treatment for patients who are asymptomatic. Patients, many of who can be young are reluctant to continue taking medications without evidence of continued benefit especially if they are experiencing side-effects. There is also a financial burden for patients in some countries. A pilot study published in the Lancet led by Dr. Sanjay Prasad at the National Heart and Lung Institute has addressed this question and shown that patients who discontinued the treatment were likely to suffer a relapse. This suggests that the improvement in cardiac function is a remission rather than a sustained recovery and withdrawal of treatment should not be considered routinely in these patients. Further research to identify parameters that will discriminate remission from recovery may enable the safe withdrawal of treatment in some patients.