Table 2.

Studies related to novel possible biomarkers for risk stratification in dilated cardiomyopathy.

Scheme	Population and Follow-Up	Characteristics	Clinical End Points	Results	Limitations
High-sensitivity-CRP (hs-CRP)
Li et al. [19]	-622 patients with DCM, retrospective cohort study, 2.6 ± 1.6 years.	-73.5% males, 51.4 ± 14.6 years; -LVEF 31.2% ± 8.5.	-33.6% all-cause mortality.	-plasma NT pro-BNP and hs-CRP at admission were strong predictors of all-cause mortality in DCM patients, independent of age, LV diameter, NYHA functional class and LVEF.	-biomarkers were measured only at admission.
Chitose et al. [16]	-84 patients with NIDCM, prospective study, 42 months.	-80.95% males, 55.9 ± 1.5 years; -LVEF 33.8% ± 1.0.	-27.38% had cardiac events; -21.42% died of cardiac causes.	-hsCRP is a useful prognostic marker in NIDCM patients, independent of hemodynamics and BNP.	-hsCRP was evaluated using only one point sampling and was not observed after treatment for HF.
Neutrophil/Lymphocyte ratio (NLR)
Avci et al. [22]	-87 patients with idiopathic DCM, prospective study.	-62.06% males, 48.7 ± 13.8 years; -LVEF 29.7% ± 6.9.	-not evaluated.	-NLR was significantly higher in patients with NYHA III or IV.	-small sample size; -other inflammatory markers were not measured.
Araujo et al. [12]	-57 pediatric patients with DCM, retrospective study, follow-up 46 ± 14 months.	-40% males, 48 ± 55.9 months, higher incidence in infants < 12 months; -LVEF 35.5% ± 9.8.	-28.1% died or were submitted to cardiac transplant.	-high NLR was associated with poor prognosis and a higher risk of death or submission to cardiac transplant.	-small sample size; -absence of a control group; -a single sample of each patient.
Chemerin
Chen et al. [31]	-214 patients with DCM, prospective study, 18 months	-61.2% males, 55 ± 7 years; -LVEF 36% ± 6.	-MACEs (cardiac mortality, stroke and myocardial infarction): 30.8% -all cause mortality: 16.8%.	-higher serum chemerin was associated with an increased risk of MACEs.	-a single measurement of serum chemerin; -NYHA functional class was not collected.
Tumor Necrosis Factor-α (TNF-α)
Chen et al. [35]	-1338 patients and 1677 controls from 9 studies, systematic metanalysis.	-67.58% males, 52.78 years.	-not evaluated.	-TNF-α G-308A polymorphism may play an important role in the pathogenesis and progression of DCM, especially in Asian populations.	-small or moderate sample sizes of the studies; -3 studies included ischemic, valvular or viral DCM.
Heart-type Fatty Acid Binding Protein (H-FABP)
Komamura et al. [53]	-92 patients with NIDCM, prospective study, 48 months	-71% males, 48.5 years; -LVEF 30% in non-survivors and 37% in survivors (p = 0.002).	-cardiac death: 14.13%; -heart transplant: 7.6%; -left ventricular assist device: 3.26%.	-H-FABP before discharge independently predicted the long-term risk of critical cardiac events in NIDCM	-small sample size.
Matrix Metalloproteinases (MMP)
Franz et al. [59]	-187 patients with DCM, prospective study, 3–6 months	-78.07 % males, 48.9 ± 12.2 years; -LVEF 31.7% ± 12.4.	-death or cardiac transplantation was higher in patients with elevated MMP-9 serum values.	-increased serum levels of MMP 9, tissue inhibitor of MMP 1, fetal tenascin-C and fibronectin are related to a lower survival of DCM patients	-small sample size.
Endothelin-A (ETA)
Herrmann et al. [70]	-125 patients with DCM, prospective study, 40 ± 21 months	-79.2 % males, 58 ± 10 years; -LVEF 32% ± 12.	-death was higher in carriers of ETA T alleles.	-role of a genetic variation in the ETA receptor on survival in DCM patients.	-small sample size.

DCM—dilated cardiomyopathy; HF—heart failure; LV—left ventricle; LVEF—left ventricular ejection fraction; MACE—major adverse cardiovascular events; NIDCM—non-ischemic dilated cardiomyopathy; NT pro-BNP—N-terminal-pro hormone BNP; NYHA—New York Heart Association.