Dilated Cardiomyopathy: A Disease of the Myocardium

Abstract

Cardiomyopathies are defined as cardiac diseases of the myocardium with associated cardiac dysfunction. They are cardiac diseases in which heart muscle disease and/or measurable deterioration of cardiac muscle function occurs due to various causes, such as genetic and sporadic mutations of muscle proteins, as well as external factors such as hypertension, ischemia, and inflammation. In 1995, the WHO/International Society and Federation of Cardiology (ISFC) classified primary cardiomyopathy caused by intrinsic factors into five groups according to the dominant pathophysiology: dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), restricted cardiomyopathy (RCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and unclassified cardiomyopathy. Among these cardiomyopathies, DCM is the most prevalent and the most common reason for cardiac transplantation in adults and children. Many recent findings indicate that genetic and sporadic mutations of a number of muscle proteins, such as myofibrillar, structural, and Ca 2+ regulating proteins, can cause DCM. In such cases, certain mutations often induce DCM with cardiac arrhythmia that is recognized as a potential trigger of sudden cardiac death. Thus, effective prognostic determination and appropriate cardiac care depend on accurate molecular and genetic diagnoses.

Targeting the sarcomere to correct muscle function

“…HCM is generally regarded as a disease of the sarcomere, whereas familial DCM is caused by a broader range of mutations, involving genes encoding not only sarcomeric proteins but also those involved in calcium handling and maintenance of structural integrity of the nucleus and cytoskeleton 112,113 . There is some overlap between DCM and arrhythmogenic right ventricular cardiomyopathy (ARVC), a condition characterized by fibro-fatty replacement of right ventricular muscle.…”

Three-Dimensional and Biomimetic Technology in Cardiac Injury After Myocardial Infarction: Effect of Acellular Devices on Ventricular Function and Cardiac Remodelling

“…DCM is the most common cardiomyopathy and has many causes. In the absence of abnormal loading condition and severe coronary artery disease, the DCM is characterized by abnormal indings of chamber size and wall thickness, left ventricular dilation and impaired contraction of the left or both ventricles [8]. This reorganization results in abnormal levels of resting tension with activation of the cell death pathway and a further reduction in myocardial performance thus establishing a vicious feedback loop [9,10].…”

Differential reversibility in heart failure due to hypothyroidism: A series of contrasting cases with review of literature

“…Dilated cardiomyopathy is a disease of the myocardium characterized by chamber dilation and reduced left ventricular systolic function in the absence of abnormal cardiovascular loading conditions [5,6]. Although in many cases no cause is identified, DCMP can be attributed to etiologies such as infectious disease, chemotherapy side effects, alcohol abuse, pregnancy, and endocrine diseases including hyperthyroidism and hypothyroidism [6,7].…”