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We explored the differences in epidemiologic, clinical, laboratory and echocardiographic characteristics between idiopathic dilated (IDCM) and ischaemic cardiomyopathy (ICM). Consecutive patients with stable chronic heart failure evaluated at a tertiary cardiac centre were enrolled. Clinical examination, blood tests and echocardiographic study were performed. A total of 76 patients (43 IDCM, 33 ICM) were studied. IDCM patients were younger (p Patients with IDCM were younger, presented lower rates of right ventricular dysfunction and clinical right ventricular failure and had better functional capacity. Additional differences in clinical and laboratory findings exist pointing to a different patient population with diverse prognosis and potential need for individualized management.

We present a case of acute decompensated heart failure in a patient with congenitally corrected transposition of great arteries treated with levosimendan, an agent with positive inotropic and vasodilatory effects. Levosimendan infusion resulted in symptomatic and functional improvement, improvement of the subpulmonary left ventricular systolic function and amelioration of the diastolic but not the systolic function of the systemic right ventricle. A number of factors may account for the poor response of the systemic right ventricle to levosimendan, such as altered myofibrillar structure and coronary flow together with the particular loading conditions of the systemic right ventricle.