CLASSIFICATIONS OF CARDIOMYOPATHIES: CURRENT STATUS
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i4.12795Keywords:
morphological characteristics, genetic factors, etiology and pathogenesis of developmentAbstract
SUMMARY. Today, myocardiopathy occupies a leading place in the overall structure of the disease. Almost 50 % of patients who die suddenly in childhood or adolescence or have a heart transplant suffer from cardiomyopathy. Its clinical and functional manifestations are sufficiently covered in the scientific literature, but not enough attention is paid to the morphological changes of the heart.
The aim – to systematize the classifications of cardiomyopathies, to identify their disadvantages and advantages, as well as to establish a new division.
Material and Methods. The classifications of cardiomyopathies set forth by Goodwin and Oakley, the European Society of Cardiology, and the American Heart Association Committee have been studied and summarized.
Results. During the analysis of the material, we found the shortcomings of the most common classifications, which prompted us to create our own division of cardiomyopathies, which is based on etiological and pathogenetic principles.
Conclusions. Currently, the two most well-known classifications are used: the American Heart Association and the European Society of Cardiology, the foundation of which was laid by Goodwin and Oakley, creating the first division, which is formed on the pathomorphological changes of the myocardium: dilated (DCM), hypertrophic (HCM), and restrictive (RCM) types of cardiomyopathy. Subsequently, new species were added: arrhythmogenic and unclassified. After analyzing both classifications, we concluded that they need editing, because in practice it is difficult for a doctor to determine the type of cardiomyopathy, which in turn leads to ineffective treatment. Based on these disadvantages, it is possible to create a new classification that best illustrates the etiological and pathogenetic division of cardiomyopathies, which is important for choosing the optimal therapy. Our classification includes autoimmune, electrolyte, post-infection, toxic and mixed.
References
McKenna, W.J., Maron, B.J., & Thiene, G. (2017). Classification, epidemiology, and global burden of cardiomyopathies. Circ. Res., 121(7), 722-730. DOI: 10.1161/CIRCRESAHA.117.309711.
Elliott, P., Andersson, B., Arbustini, E., Bilinska, Z., Cecchi, F., Charron, P., …, & Keren, A. (2008). Classification of the cardiomyopathies: a position statement from the european society of cardiology working group on myocardial and pericardial diseases. Eur. Heart J., 29(2), 270-276. DOI: 10.1093/eurheartj/ehm342.
Ammirati, E., Veronese, G., Bottiroli, M., Wang, D.W., Cipriani, M., Garascia, A., …, & Frigerio, M. (2020). Update on acute myocarditis. Trends Cardiovasc. Med., 31(6), 1050-1738. DOI: 10.1016/j.tcm.2020.05.008.
Evans, W. (1949). Familial cardiomegaly. Br. Heart J., 11 (1), 68-82. DOI: 10.1136/hrt.11.1.68.
Brigden, W. (1957). Uncommon myocardial diseases: the non-coronary cardiomyopathies. Lancet, 273(7008), 1243-1249. DOI: 10.1016/s0140-6736(57)91537-4.
(1980). Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br. Heart J., 44(6), 672-673. DOI: 10.1136/hrt.44.6.672.
Angelini, A., Calzolari, V., Thiene, G., Boffa, G.M., Valente, M., Daliento, L., …, & Chioin, R. (1997). Morphologic spectrum of primary restrictive cardiomyopathy. Am. J. Cardiol., 80(8), 1046-1050. DOI: 10.1016/s0002-9149(97)00601-2.
Geisterfer-Lowrance, A.A., Kass, S., Tanigawa, G., Vosberg, H.P., McKenna, W., Seidman, C.E., & Seidman, J.G. (1990). A molecular basis for familial hypertrophic cardiomyopathy: a beta cardiac myosin heavy chain gene missense mutation. Cell, 62(5), 999-1006. DOI: 10.1016/0092-8674(90)90274-i.
Olson, T.M., Michels, V.V., Thibodeau, S.N., Tai, Y.S., & Keating, M.T. (1998). Actin mutations in dilated cardiomyopathy, a heritable form of heart failure. Science, 280(5364), 750-752. DOI: 10.1126/science.280.5364.750.
Richardson, P., McKenna, W., Bristow, M., Maisch, B., Mautner, B., O’Connell, J., …, & Nordet, P. (1996). Report of the 1995 World Health Organization. International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation, 93(5), 841-842. DOI: 10.1161/01.cir.93.5.841.
Thiene, G., Nava, A., Corrado, D., Rossi, L., & Pennelli, N. (1988). Right ventricular cardiomyopathy and sudden death in young people. N. Engl. J. Med., 318(3), 129-133. DOI: 10.1038/nrcardio.2016.207.
Angelini, A., Melacini, P., Barbero, F., & Thiene, G. (1999). Evolutionary persistence of spongy myocardium in humans. Circulation, 99(18), 2475. DOI: 10.1161/01.cir.99. 18.2475.
Finsterer, J., Stöllberger, C., & Towbin, J. A. (2017). Left ventricular noncompaction cardiomyopathy: cardiac, neuromuscular, and genetic factors. Nat. Rev. Cardiol., 14(4), 224-237. DOI: 10.1038/nrcardio.2016.207.
He, Y., Chipman, P.R., Howitt, J., Bator, C.M., Whitt, M.A., Baker, T.S., …, & Rossmann, M.G. (2001). Interaction of coxsackievirus B3 with the full length coxsackievirus-adenovirus receptor. Nat. Struct. Biol., 8(10), 874-878. DOI: 10.1038/nsb1001-874.
Badorff, C., Lee, G.H., Lamphear, B.J., Martone, M.E., Campbell, K.P., Rhoads, R.E., & Knowlton, K.U. (1999). Enteroviral protease 2A cleaves dystrophin: evidence of cytoskeletal disruption in an acquired cardiomyopathy. Nat Med., 5(3), 320-326. DOI: 10.1038/6543.
Rampazzo, A., Nava, A., Malacrida, S., Beffagna, G., Bauce, B., Rossi, V., …, & Danieli, G.A. (2002). Mutation in human desmoplakin domain binding to plakoglobin causes a dominant form of arrhythmogenic right ventricular cardiomyopathy. Am. J. Hum. Genet., 71(5), 1200-1206. DOI: 10.1086/344208.
Mogensen, J., Kubo, T., Duque, M., Uribe, W., Shaw, A., Murphy, R., …, & McKenna, W.J. (2003). Idiopathic restrictive cardiomyopathy is part of the clinical expression of cardiac troponin I mutations. J. Clin. Invest., 111(2), 209-216. DOI: 10.1172/JCI16336.
Thiene, G., Corrado, D., & Basso, C. (2004). Cardiomyopathies: is it time for a molecular classification. Eur. Heart J., 25(20), 1772-1775. DOI: 10.1016/j.ehj.2004.07.026.
Maron, B.J., Towbin, J.A., Thiene, G., Antzelevitch, C., Corrado, D., Arnett, D., …, & Young, J.B. (2006). Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee. Circulation, 113(14), 1807-1816. DOI: 10.1161/CIRCULATIONAHA.106.174287.
Elliott, P., Andersson, B., Arbustini, E., Bilinska, Z., Cecchi, F., Charron, P., …, & Keren, A. (2008). Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur. Heart J., 29(2), 270-276. DOI: 10.1093/eurheartj/ehm342.
van Rijsingen, I.A., Arbustini, E., Elliott, P.M., Mogensen, J., Hermans-van Ast, J.F., van der Kooi, A.J., …, & Pinto, Y.M. (2012). Risk factors for malignant ventricular arrhythmias in lamin a/c mutation carriers a European cohort study. J. Am. Coll. Cardiol., 59(5), 493-500. DOI: 10.1016/j.jacc.2011.08.078.
Lipshultz, S.E., Sleeper, L.A., Towbin, J.A., Lowe, A.M., Orav, E.J., Cox, G.F., …, & Colan, S.D. (2003). The incidence of pediatric cardiomyopathy in two regions of the United States. N. Engl. J. Med., 348(17), 1647-1655. DOI: 10.1056/NEJMoa021715.
Bagnall, R.D., Weintraub, R.G., Ingles, J., Duflou, J., Yeates, L., Lam, L., …, & Semsarian, C. (2016). A prospective study of sudden cardiac death among children and young adults. N. Engl. J. Med., 374(25), 2441-2452. DOI: 10.1056/NEJMoa1510687.
Thiene, G. (2014). Sudden cardiac death and cardiovascular pathology: from anatomic theater to double helix. Am. J. Cardiol., 114(12), 1930-1936. DOI: 10.1016/j.amjcard.2014.09.037.
Maron, B.J., Gardin, J.M., Flack, J.M., Gidding, S.S., Kurosaki, T.T., & Bild, D.E. (1995). Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary Artery Risk Development in (Young) Adults. Circulation, 92(4), 785-789. DOI: 10.1161/01.cir.92.4.785.
Holst, A.G., Jensen, H.K., Eschen, O., Henriksen, F.L., Kanters, J., Bundgaard, H., …, & Tfelt-Hansen, J. (2012). Low disease prevalence and inappropriate implantable cardioverter defibrillator shock rate in Brugada syndrome: a nationwide study. Europace, 14(7), 1025-1029. DOI: 10.1093/europace/eus002.
Junttila, M.J., Raatikainen, M.J., Karjalainen, J., Kauma, H., Kesäniemi, Y.A., & Huikuri, H.V. (2004). Prevalence and prognosis of subjects with Brugada-type ECG pattern in a young and middle-aged Finnish population. Eur. Heart. J., 25(10), 874-878. DOI: 10.1016/j.ehj.2004.01.011.
Postema, P.G. (2012). About Brugada syndrome and its prevalence. Europace, 14(7), 925-928. DOI: 10.1093/europace/eus042.
Priori, S.G., Wilde, A.A., Horie, M., Cho, Y., Behr, E.R., Berul, C., …, & Tracy, C. (2013). HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm., 10(12), 1932-1963. DOI: 10.1016/j.hrthm.2013. 05.014.
Schwartz, P.J., Stramba-Badiale, M., Crotti, L., Pedrazzini, M., Besana, A., Bosi, G., …, & Spazzolini, C. (2009). Prevalence of the congenital long-QT syndrome. Circulation, 120(18), 1761-1767. DOI: 10.1161/CIRCULATIONAHA. 109.863209.
Merner, N.D., Hodgkinson, K.A., Haywood, A.F., Connors, S., French, V.M., Drenckhahn, J.D., …, & Young, T.L. (2008). Arrhythmogenic right ventricular cardiomyopathy type 5 is a fully penetrant, lethal arrhythmic disorder caused by a missense mutation in the TMEM43 gene. Am. J. Hum. Genet., 82(4), 809-821. DOI: 10.1016/j.ajhg.2008.01.010.
van der Zwaag, P.A., van Rijsingen, I.A., de Ruiter, R., Nannenberg, E.A., Groeneweg, J.A., Post, J.G., …, & van Tintelen, J.P. (2013). Recurrent and founder mutations in the Netherlands-Phospholamban p.Arg14del mutation causes arrhythmogenic cardiomyopathy. Neth Heart J., 21(6), 286-293. DOI: 10.1007/s12471-013 0401-3.
Hershberger, R.E., Hedges, D.J., & Morales, A. (2013). Dilated cardiomyopathy: the complexity of a diverse genetic architecture. Nat. Rev. Cardiol., 10(9), 531-547. DOI: 10.1038/nrcardio.2013.105.
Marcus, F.I., McKenna, W.J., Sherrill, D., Basso, C., Bauce, B., Bluemke, D.A., …, & Zareba, W. (2010). Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the task force criteria. Circulation, 121(13), 1533-1541. DOI: 10.1161/CIRCULATIONAHA.108.840827.
Nava, A., Bauce, B., Basso, C., Muriago, M., Rampazzo, A., Villanova, C., …, & Thiene, G. (2000). Clinical profile and long-term follow-up of 37 families with arrhythmogenic right ventricular cardiomyopathy. J. Am. Coll. Cardiol., 36(7), 2226-2233.
Zareba, W., Moss, A.J., Schwartz, P.J., Vincent, G.M., Robinson, J.L., Priori, S.G., …, & Hall, W.J. (1998). Influence of the genotype on the clinical course of the long-QT syndrome. International Long-QT Syndrome Registry Research Group. N. Engl. J. Med., 339(14), 960-965. DOI: 10.1056/NEJM199810013391404.
Tsuneoka, H., Takagi, M., Murakoshi, N., & Yamagishi, K. (2016). ECG and ECG with atypical ST-segment elevation in the right precordial leads over 20 years: results from the Circulatory Risk in Communities Study (CIRCS). J. Am. Heart Assoc, 5(8), e002899. DOI: 10.1161/JAHA.115.002899.
Nannenberg, E.A., Sijbrands, E.J., Dijksman, L.M., Alders, M., van Tintelen, J.P., Birnie, M., ..., & Wilde, A.A. (2012). Mortality of inherited arrhythmia syndromes: insight into their natural history. Circ. Cardiovasc. Genet., 5(2), 183-189. DOI: 10.1161/CIRCGENETICS.111.961102.
Imberti, J.F., Underwood, K., Mazzanti, A., & Priori, S.G. (2016). Clinical challenges in catecholaminergic polymorphic ventricular tachycardia. Heart Lung Circ., 25(8), 777-783. DOI: 10.1016/j.hlc.2016.01.012.
Adler, E., & Fuster, V. (2005). SCN5A – a mechanistic link between inherited cardiomyopathies and a predisposition to arrhythmias. JAMA, 293(4), 491-493. DOI: 10.1001/jama.293.4.491.
Burkett, E.L., & Hershberger, R.E. (2005). Clinical and genetic issues in familial dilated cardiomyopathy. J. Am. Coll. Cardiol., 45(7), 969-981. DOI: 10.1016/j.jacc. 2004.11.066.
Bodnar, Ya.Ya. (1988). Strukturnyye izmeneniya miokarda pri nekotorykh vidakh narusheniya vodnoelektrolitnogo balansa organizma [Structural changes in the myocardium in some types of violation of the water-electrolyte balance of the body]. Morfologiya – Morphology, 11, 52-54 [in Russian].
Holovata, T.K., Bodnar, Ya.Ya. (2008). Patohistolohichni zminy elementiv stromy sertsia pry khronichnii alkoholnii intoksykatsii [Pathohistological changes in the elements of the stroma of the heart in chronic alcohol intoxication]. Tavrycheskyy medyko-byolohycheskyy vesnyk – Taurida Medical and Biological Bulletin, 11(1), 79-81 [in Ukrainian].
Phillips, K., Luk, A., Soor, G.S., Abraham, J.R., Leong, S., & Butany, J. (2021). Cocaine cardiotoxicity: a review of the pathophysiology, pathology, and treatment options. Cureus, 13(4), 177-196. DOI: 10.7759/cureus.14594.
Duflou, J. (2020). Psychostimulant use disorder and the heart. Addiction, 115 (1), 175-183. DOI: 10.1111/add.14713.
Kozhukhov, S.N., Dovganich, N.V., Fedkiv, S.V., & Rybak, A.Yu. (2019). Toksicheskaya kardiomiopatiya, oslozhnennaya vnutripolostnym trombozom i venoznym tromboembolizmom [Toxic cardiomyopathy complicated by intracavitary thrombosis and venous thromboembolism]. Spetsvypusk «Klinichni vypadky ta stsenarii u nevidkladnii kardiolohii» – Special issue "Clinical cases and scenarios in emergency cardiology" [in Russian].
Amosova, E.N. (1999). Kardiomiopatii [Cardiomyopathy]. Кyiv: Knyha plius [in Ukrainian].
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Achievements of Clinical and Experimental Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
