Cardiomyopathies and Heart Failure - Biomolecular, Infectious and Immune Mechanisms

DUCTORYCHAPTER CARDIOMYOPATHIESANDHEARTFAILURE Biomolecular,InfectiousandImmuneMechanisms AkiraMatsumori,MD,PhD DepartmentofCardiovascularMedicine KyotoUniversityGraduateSchoolofMedicine Kyoto,Japan 1 SUMMARY Theclinicalpresentationofviralmyocarditisisvariable. Whenmyocardial necrosis is diffuse, congestive heart failure develops, and later, dilated cardiomyopathy. If the myocardial lesions are localized, a ventricular aneurysmforms. Whencomplicatedbyarrhythmias,myocarditispresentsas arrhythmogenic right ventricular cardiomyopathy. When myocardial necrosisislocalizedtothesubendocardialregion,restrictivecardiomyopathy may develop. While it has not been established that hypertrophic cardiomyopathy maybeacomplicationofviral myocarditis, asymmetrical septal hypertrophy has, in fact, sometimesbeen observed in patients with myocarditis. TheimportanceofhepatitisCvirusinfectionhasrecentlybeen notedinpatientswithmyocarditis,dilatedandhypertrophiccardiomyopathy.