Cardiomyopathy historical perspective
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References
Template:WH Template:WS In 1980, the World Health Organization (WHO) defined cardiomyopathies as "heart muscle diseases of unknown cause" to distinguish cardiomyopathy from cardiac dysfunction due to known cardiovascular causes such as hypertension, ischemic heart disease, or valvular disease. In clinical practice, however, the term "cardiomyopathy" had also been applied to diseases of known cardiovascular cause, including ischemic cardiomyopathy and hypertensive cardiomyopathy. As a result, the 1995 WHO/International Society and Federation of Cardiology (ISFC) Task Force on the Definition and Classification of the Cardiomyopathies expanded the classification to include all diseases affecting heart muscle and to take into consideration etiology as well as the dominant pathophysiology. In the 1995 classification, the cardiomyopathies were defined as "diseases of the myocardium associated with cardiac dysfunction." They were classified according to anatomy and physiology into the following types: ●Dilated cardiomyopathy (DCM) ●Hypertrophic cardiomyopathy (HCM) ●Restrictive cardiomyopathy (RCM) ●Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) ●Unclassified cardiomyopathies Then, a 2006 AHA scientific statement proposed a contemporary definition and classification of the cardiomyopathies: "Cardiomyopathies are a heterogeneous group of diseases of the myocardium associated with mechanical and/or electrical dysfunction that usually (but not invariably) exhibit inappropriate ventricular hypertrophy or dilation and are due to a variety of causes that frequently are genetic. Cardiomyopathies either are confined to the heart or are a part of generalized systemic disorders, often leading to cardiovascular death or progressive heart failure-related disability." As such, cardiomyopathies are categorized into two groups: 1- Primary cardiomyopathies (predominantly involving the heart): The primary cardiomyopathies are subdivided into those which are genetic, mixed (predominantly nongenetic; less commonly genetic), or acquired. A- The genetic cardiomyopathies include HCM, ARVC/D, left ventricular noncompaction, PRKAG2 and Danon glycogen storage diseases, conduction defects, mitochondrial myopathies, and ion channel disorders. B- The mixed cardiomyopathies include DCM and RCM. C- The acquired cardiomyopathies include myocarditis, stress-induced (takotsubo), peripartum and tachycardia-induced. 2- Secondary cardiomyopathies (accompanied by other organ system involvement). Then, in 2008, the ESC working group on myocardial and pericardial diseases presented an update to the WHO/ISFC classification in which cardiomyopathy was defined as: "A myocardial disorder in which the heart muscle is structurally and functionally abnormal in the absence of coronary artery disease, hypertension, valvular disease and congenital heart disease sufficient to explain the observed myocardial abnormality". Despite that, the term "cardiomyopathy" continues to be used in patients with ischemic, hypertensive, valvular and congenital heart diseases.
References:
1-Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br Heart J 1980; 44:672.
2- Richardson P, McKenna W, Bristow M, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation 1996; 93:841.