Summary Lecture 5 Cardiomyopathies current status & challenges.

Cardiomyopathies current status & challenges
Cardiomyopathy and the history
Disease of the heart muscle that makes it harder for the heart to pump blood to the
rest of the body. The heart may relax or contract less well.

A distinction was made between:
 Primary cardiomyopathy: cardiomyopathy with unknown etiology (oorzaak)
o Genetic cardiomyopathy
 HCM; hypertrophic cardiomyopathy
 ARVC/D; arrhythmogenic right ventricular cardiomyopathy
 LVNC; left ventricular non-compaction cardiomyopathy
 Glycogen storage
 Conduction defects; how signals are transduced inside of the
heart muscle
 Micothondiral myopathies
 Ion channel disorders
 LQTS
 Brugada
o Acquired cardiomyopathy
 Inflammatory (myocarditis)
 Stress-provoked; tako tsubo cardiomyopathy (broken heart
syndrome)
 Peripartum; problems with the heart around the pregnancy
 Tachycardia-induced; when the heart is being stress because it
is it is beating too fast
 Infants of insulin-dependent diabetic mothers
o Mixed cardiomyopathy: need genetic and acquired
 DCM; dilated cardiomyopathy
 Restrictive cardiomyopathy
 Secondary cardiomyopathy: cardiomyopathy with known etiology
(oorzaak)/system disease

Remodelling of the heart
Remodelling of the heart takes place when there is a disease

Causes of remodelling of the heart:
 Idiopathic cardiomyopathy; we don’t know what the cause is
 Ischemic cardiomyopathy; heart muscle is diseased because of reduction of
proper blood flow into the heart
 Diabetic cardiomyopathy; related to people with type I and type II diabetes
 Familial (genetic) cardiomyopathy

2 forms of remodelling:
1. Eccentric remodelling (systolic heart failure):
heart dilates with large left ventricle – able to
fill well but not able to eject well (reduced
ejection fraction)
2. Concentric remodelling (diastolic heart
failure): heart muscle become enlarged so
less space for blood in the heart– not able to