Heart Muscle Disease PDF
Preview Heart Muscle Disease
HEART MUSCLE DISEASE @Q00 . I mr~1fQ0f3 Cf( CLINICAL CARDIOLOGY HEART MUSCLE DIS.EASE Edited .... J.F.Gooclwln Emeritus Professor of Clinical Cardiology Royal Postgraduate Medical School London MTP PRESS LIMITED ~ ~ a member of the KLUWER ACADEMIC PUBLISHERS GROUP LANCASTER I BOSTON I THE HAGUE I DORDRECHT Published in the UK and Europe by MTP Press Limited Falcon House Lancaster, England British Library Cataloguing in Publication Data Heart muscle disease.-(Current status of clinical cardiology). 1. Heart-Muscle-Diseases I. Goodwin, J.F. II. Series 616.1'24 RC685.M9 Published in the USA by MTP Press A division of Kluwer Boston Inc 190 Old Derby Street Hingham, MA 02043, USA Library of Congress Cataloging in Publication Data Main entry under title: Heart muscle disease. (Current status of clinical cardiology) Includes bibliographies and index. 1. Heart-Muscle-Diseases. I. Goodwin, John F. II. Series. [DNLM: 1. Myocardial Diseases. WG 280 H437] RC685.M9H38 1985 616.1'24 85-7121 ISBN-13: 978-94-010-8657-8 e-ISBN-13: 978-94-009-4874-7 DOl: 10.1007/978-94-009-4874-7 Copyright © 1985 MTP Press Limited Softcover reprint of the hardcover 1s t edition 1985 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from the publishers. Contents Preface Vll List of Contributors Vlll Series Editor's Note xu 1 Cardiomyopathies and specific heart muscle diseases: definition, terminology and classification 1 J.F. Goodwin 2 Hypertrophic cardiomyopathy 7 2.1 Pathogenesis of hypertrophic cardiomyopathy 7 J.K. Perloff 2.2 Clinical aspects and investigations 23 J.F. Goodwin 2.3 Treatment and prognosis 35 D.D. Sugrue and W.J. McKenna 3 Dilated (congestive) cardiomyopathy 57 3.1 Pathology, causes and relation to myocarditis 57 E.G.J. Olsen 3.2 Clinical aspects, treatment and prognosis 75 R.O. Brandenburg 4 Restrictive cardiomyopathy 87 J. Davies 5 Specific heart muscle diseases 95 N.K. Wenger 6 Amyloid heart disease 141 CM. Oakley Controversies in Cardiomyopathy 7 Hypertrophic cardiomyopathy -the obstructive dilemma 157 7.1 A non-obstructive view of hypertrophic cardiomyopathy 157 J.M. Criley and R.J. Siegel v CONTENTS 7.2 Haemodynamic, angiographic and echocardiographic evi dence against impeded ejection in hypertrophic car- diomyopathy 187 J.P. Murgo and J. W. Miller 7.3 Evidence for the importance of obstruction in hypertrophic cardiomyopathy H. Kuhn 213 7.4 Muscular sub aortic stenosis (hypertrophic obstructive car diomyopathy) the evidence for obstruction to left ventricular outflow 217 E.D. Wigle, M. Henderson, C. Pollick, Z. Sasson and H. Rakowski 8 Dilated (congestive) cardiomyopathy - the evidence for and against a disorder of cellular immunity and infection 263 8.1 The evidence against a disorder of cellular immunity and infection 263 P.J. Lowry and W.A. Littler 8.2 Dilated cardiomyopathy - arguments for immunological relevance 273 H.-D. Bolte Index 285 vi Preface Twenty five years ago, cardiomyopathies or myocardopathies as they were sometimes called, were in very small print, and often the terms myocarditis and cardiomyopathy were used interchangeably. Now definition and classifi cation can be precise and terminology has been refined. Although a great deal still has to be learnt about the heart muscle diseases, they have now achieved the status of an important group of cardiovascular disorders. Their importance is out of proportion to their frequency because the cardiomyopathies so often attack young otherwise active and healthy people, and are notable for sudden unexpected death, and for intractable congestive heart failure. They are especially a meance in age groups younger than those most commonly effected by coronary heart disease. This book presents an analysis and review by many experts of the present knowledge about heart muscle diseases and employs the approach to classi fication and terminology now generally, though not universally, agreed. It will be apparent that much fundamental research must be done now that the clinical problems have been defined. In the future, the collaboration of molecular biologists and other basic scientists will be needed to illuminate the dark places of our ignorance. Knowledge is promoted by the stimulus of argument and counter argument over controversial issues, and so, because of the importance of certain differing viewpoints on causation and function, the last two chapters deal with the significance of outflow tract gradients in hypertrophic cardio myopathy and with the infectious/immune theory of causation of dilated cardiomyopathy, respectively. The preface to the last two chapters (p. 155) will attempt to justify this selection. J.F. Goodwin vii List of Contributors H.-D. Bolte M. Henderson Zentral Klinikum Augsburg Division of Cardiology D-8900 Augsberg 12 Eaton N, Room 217B West Germany Toronto General Hospital 101 College Street Toronto, Ontario R.O. Brandenburg CANADAM5G 1L7 Cardiovascular Division The Mayo Clinic H.Kuhn Rochester, MN 55905 Stadtische Krankenanstalten USA Bielefeld Mitte Medizinische Klinik II Akademisches Lehrkrankenhaus der ].M. Criley Universitat Munster Division of Cardiology D-4BOO Bielefeld 1 Harbor - UCLA Medical Center West Germany 1000 West Carson Street Torrance, CA 90509 USA W.A. Littler Department of Cardiovascular Medicine ]. Davies University of Birmingham Department of Cardiology East Birmingham Hospital Royal Gwent Hospital Bordesley Green East Newport Birmingham B9 5ST Gwent, South Wales UK UK P.]. Lowry ].F. Goodwin Department of Cardiovascular Department of Clinical Cardiology Medicine Royal Postgraduate Medical School University of Birmingham Hammersmith Hospital East Birmingham Hospital Ducane Road Bordesley Green East London W12 OHS Birmingham B9 5ST UK UK viii HEART MUSCLE DISEASE W.J. McKenna University of California Department of Clinical Cardiology Los Angeles, CA90024 Royal Postgraduate Medical School USA Ducane Road London W12 OHS e. Pollick Uk Division of Cardiology 12 Eaton N, Room 217B J.W. Miller Toronto General Hospital US Army Medical Corps 101 College Street Cardiology Service Toronto, Ontario Department of Medicine Canada M5G 1L7 Brooke Army Medical Center Fort Sam Houston TX 78234-6200 H.R. Rakowski USA Division of Cardiology 12 Eaton N, Room 217B J.P. Murgo Toronto General Hospital US Army Medical Corps 101 College Street Cardiology Service Toronto, Ontario Department of Medicine Canada M5G 1L7 Brooke Army Medical Center Fort Sam Houston TX 78234-6200 W.e. Roberts USA Division of Cardiology Departments of Medicine and e. Oakley Pediatrics Department of Medicine Center for the Health Sciences Hammersmith Hospital and University of California The Royal Postgraduate Medical Los Angeles School California Ducane Road USA London W12 OHS UK z. Sasson Division of Cardiology E.G.J. Olsen 12 Eaton N, Room 217B Department of Morbid Anatomy Toronto General Hospital and Histopathology 101 College Street National Heart and Chest Hospitals Toronto, Ontario Westmorland Street Canada M5G 1L7 London W1M BA UK R.J. Siegel J .K. Perloff Division of Cardiology Division of Cardiology RM 47-123 Harbor - UCLA Medical Center Departments of Medicine ana 1000 West Carson Street Pediatrics Torrance, CA 90509 Center for the Health Sciences USA ix LIST OF CONTRIBUTORS D.O. Sugrue 69 Butler Street, SE Department of Cardiovascular Atlanta, GA 30303 Disease USA Mayo Clinic Rochester, MN 55904 USA E.D. Wigle Division of Cardiology N.K. Wenger 12 Eaton N, Room 217B Department of Medicine Toronto General Hospital (Cardiology) 101 College Street Emory University School of Toronto, Ontario Medicine Canada M5G lL7 x Current Status of Clinical Cardiology Series Drugs in the Management of Heart Disease Edited by A. Breckenridge Heart Muscle Disease Edited by J. F. Goodwin Congenital Heart Disease Edited by F.J. Macartney Invasive and Non-Invasive Diagnosis of Heart Disease Edited by A. Maseri Ischaemic Heart Disease Edited by K. Fox Immunology and Heart Disease Edited by C.J.F. Spry xi
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