Advertisement

Dilated Cardiomyopathy: Pathogenesis and Treatment

  • J. E. Parrillo
Conference paper
  • 64 Downloads
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 1)

Abstract

Dilated cardiomyopathy refers to a serious form of heart disease characterized by a primary abnormality of the cardiac myocardium. In this form of heart disease, the myocardium becomes dysfunctional and leads to dilatation of the cardiac chambers (most characteristically, the left ventricle). By definition, coronary atherosclerosis, valvular heart disease, congenital heart disease, and hypertensive heart disease have been excluded. Based on a thorough evaluation employing clinical symptoms and signs and further evaluation by EKG, chest x-ray. echocardiography, radionuclide gated blood pool scan, and cardiac catheterization, other causes of a dilated cardiomyopathic ventricle have been excluded. The poor systolic myocardial dysfunction must result from weakness of the myocardium itself. Although some authors choose to designate heart failure due to coronary disease as a form of “dilated cardiomyopathy”, most investigators (including myself) reserve the term dilated cardiomyopathy for primary myocardial dysfunction, after excluding the other causes of heart disease listed above.

Keywords

Dilate Cardiomyopathy Endomyocardial Biopsy Idiopathic Dilate Cardiomyopathy Hypertensive Heart Disease Keshan Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburgh RO, Frye RL (1981) The Natural History of Idiopathic Dilated Cardiomyopathy. Am J Cardiol 47; 3: 525–531PubMedCrossRefGoogle Scholar
  2. 2.
    Bristow MR, Mason JW, Billingham ME, Daniels JR (1978) Doxorubicin Cardiomypathy: Evaluation by Phonocardiography, Endomyocardial Biopsy, and Cardiac Catheterization. Ann Inter Med 88: 168–175Google Scholar
  3. 3.
    Buja LM, Roberts WC (1971) Iron in the Heart. Am J Med 51: 209–221PubMedCrossRefGoogle Scholar
  4. 4.
    Parrillo JE, Aretz HT, Palacios I, Fallon JT, Block PC (1984) The Results of Transvenous Endomyocardial Biopsy Can Frequently be Used to Diagnose Myocardial diseases in Patients With Idiopathic Heart Failure: Endomyocardial Biopsies in 100 Consecutive Patients Revealed a Substantial Incidence of Myocarditis. Circulation 69: 1: 93–101PubMedCrossRefGoogle Scholar
  5. 5.
    Matsumori Akira, Kawai Chuichi (1982) An Animal Model of Congestive (Dilated) Cardiomyopathy: Dilation and Hypertrophy of the Heart in the Chronic Stage in DBA/2 Mice with Myocarditis Caused by Encephalomyocarditis Virus. Circulation 66; 2: 355–360PubMedCrossRefGoogle Scholar
  6. 6.
    Fowles RE, Bieber CP, Stinson EB (1979) Defective In Vitro Suppressor Cell Function in Idiopathic Congestive Cardiomyopathy. Circulation 59; 3: 483–491PubMedCrossRefGoogle Scholar
  7. 7.
    O’Connell JB, Robinson JA, Henkin RE, Gunnar RM (1981) Immunosuppressive Therapy in Patients with Congestive Cardiomyopathy and Myocardial Uptake of Gallium-67. Circulation 64: 780–786PubMedCrossRefGoogle Scholar
  8. 8.
    O’Connell JB, Henkin RE, Robinson JA, Subramanian R, Scanlon PJ (1984) Gallium-67 Imaging in Patients With Dilated Cardiomyopathy and Biopsy-proven Myocarditis.“ Circulation 70; 1: 58–62Google Scholar
  9. 9.
    Mason JW, Billingham ME, Ricci DR (1980) Treatment of Acute Inflammatory Myocarditis Assisted by Endomyocardial Biopsy. Am J Cardiol 45: 1037–1044PubMedCrossRefGoogle Scholar
  10. 10.
    Fenoglio JJ, Ursell PC, Kellogg CF, Drusin RE, Weiss MB (1983) Diagnosis and Classification of Myocarditis by Endomyocardial Biopsy. N Engl J Med 308: 1: 12–18PubMedCrossRefGoogle Scholar
  11. 11.
    Parrillo JE (1983) Inflammatory Myopericarditis. Curr Ther Allergy Immunol pp 258–265Google Scholar
  12. 12.
    Hosenpud HD, McAnulty JH, Niles NR (1985) Lack of Objective Improvement in Ventricular Systolic Function in Patients with Myocarditis Treated With Azathioprine and Prednisone JACC 6; 4: 797–801Google Scholar
  13. 13.
    Parrillo JE, Cunnion RE, Epstein SE, Palmeri S, Parker MM, Brenner M, Suffredini AF, Schaer GL, Rosing DS, Ailing DW, Keenan AM, Rodriquez ER, Ferrans VJ, Fauci AS (1986). Lack of Correlation Among Myocardial Histology, Myocardial Immunofluoresence, Cardiac Gallium Scanning, and Erythocyte Sedimentation Rate in Idiopathic Dilated Cardiomyopathy. Clin Res 34 (in press)Google Scholar
  14. 14.
    Parrillo JE, Cunnion RE, Epstein SE, Palmieri S, Parker MM, Brenner M, Suffredini AF, Schear GL, Rosing DS, Ailing DW, Rodriquez ER, Ferrans VJ, Fauci AS (1986) “Baseline Characteristics and Natural History in 67 Patients with Idiopathic Dilated Cardiomyopathy.” Clin Res 34 (in press)Google Scholar
  15. 15.
    Factor SM, Sonnenblick EH (1982) Hypothesis: Is Congestive Cardiomyopathy. Caused By a Hyperreactive Myocardial Microcirculation (Microvascular Spasm)? Am J Cardiol 50; 1149–1152Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • J. E. Parrillo

There are no affiliations available

Personalised recommendations