Reversible Cardiomyopathies

Abstract

Cardiomyopathies (CMs) have many etiological factors that can result in severe structural and functional dysregulation. Fortunately, there are several potentially reversible CMs that are known to improve when the root etiological factor is addressed. In this article, we discuss several of these reversible CMs, including tachycardia-induced, peripartum, inflammatory, hyperthyroidism, Takotsubo, and chronic illness–induced CMs. Our discussion also includes a review on their respective pathophysiology, as well as possible management solutions.

Early Implantation of Primary Prevention Implantable Cardioverter Defibrillators for Patients with Newly Diagnosed Severe Nonischemic Cardiomyopathy

“…The underlying etiology of cardiomyopathy is also an important factor to consider when predicting likelihood of recovery. Patients whose cardiomyopathy is tachycardia‐mediated, stress‐induced (Takotsubo), peripartum, or related to potentially reversible metabolic factors (e.g., thyroid disease) have a more favorable prognosis . However, even in our cohort of mostly idiopathic dilated cardiomyopathy and myocarditis patients (Table ), there were significant improvements in LV systolic function that may occur over time.…”

5-Fluorouracil-induced acute reversible heart failure not explained by coronary spasms, myocarditis or takotsubo: lessons from MRI

“…Indeed, to ascertain that our patient suffered from ATP depletion, it would have required myocardial 31 phosphate MR spectroscopy in the acute phase, but we find it intriguing that she did demonstrate findings that were fully in line with a mechanism implicating lowered energy supply (uniformly depressed cardiac function, quick recovery and no findings on CMR implicating well-known mechanisms). In a recently published review, myocardial ATP depletion was implicated as the cause of reversible tachycardia-induced cardiomyopathies,29 and the ‘engine out of fuel’ hypothesis was proposed for lowered ATP generation in a number of cardiomyopathies 30. It is interesting that, despite animal experiments demonstrating myocardial ATP-depletion with 5-FU, this mechanism is rarely discussed in the literature on 5-FU cardiotoxicity.…”

Peripartum Cardiomyopathy (PPCM): Dual Case Report and Review of Literatures

“…Survivors of PPCM have 30 % risk of relapse [4] and significant decrease of left ventricular function [25] in subsequent pregnancies with reported 55% mortality and morbidity rates associated with recurrence in subsequent pregnancy [26]. One explanation would be that patients who entered the subsequent pregnancy with abnormal systolic function, without making a complete recovery from the first PPCM in prior pregnancy [27].…”