Papillary Muscle Scarring Linked to Increased Cardiac Risk in Dilated Cardiomyopathy Patients
CHICAGO – A new study published October 15, 2025, in JAMA Cardiology reveals that teh presence of scarring on the papillary muscles of the heart – termed “papSCAR” – may serve as a meaningful predictor of cardiac death and adverse outcomes in patients diagnosed with dilated cardiomyopathy (DCM). Researchers found that papSCAR was associated with a heightened risk across the spectrum of DCM severity, potentially identifying patients who would benefit from closer monitoring or more aggressive interventions.
Dilated cardiomyopathy, a condition where the heart’s main pumping chamber enlarges and weakens, affects millions worldwide and is a leading cause of heart failure. currently, risk stratification in DCM relies on factors like ejection fraction and the presence of fibrosis in the heart muscle. this research suggests papSCAR could be an early indicator of risk,offering a new tool for clinicians to identify vulnerable patients before significant deterioration occurs. The findings underscore the need for further inquiry into the underlying causes and mechanisms of papillary muscle scarring.
The study, conducted by researchers at a single center, analyzed data from patients with DCM and found that papSCAR was associated with increased left ventricle wall stretch, generating greater tension and stroke volume. This “longitudinal shortening,” as described by the study authors, suggests a compensatory mechanism that may ultimately prove unsustainable.
Though, the researchers acknowledge limitations, including the single-center design which could introduce bias and limit the broad applicability of the results.They also noted that genetic factors and the role of microvascular dysfunction were not evaluated.
“these findings show that papSCAR provides prognostic value across the spectrum of patients with DCM and suggest that papSCAR may be an early marker of risk,” the study authors concluded. Future research, including multicenter studies incorporating genetic and perfusion data, is planned to validate these findings and refine the understanding of papillary muscle scarring in DCM.
Reference:
- Kaolawanich Y, Wendell DC, Kim HW, et al.Prognostic value of papillary muscle scarring in patients with dilated cardiomyopathy. JAMA Cardiol. Published online October 15, 2025. doi:10.1001/jamacardio.2025.3822
- Dilated cardiomyopathy (DCM). American Heart Association. Last Reviewed May 28, 2024. Accessed October 16, 2025. https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/dilated-cardiomyopathy-dcm
