Cardiomyopathies–From Basic Research To Clinical Management

Peripartum Cardiomyopathy: A Systematic Review (Classification, Evaluation and Management of Cardiomyopathies) Part 1

Introduction Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening condition that occurs in previously healthy women during the last month of pregnancy and up to 5-6 months postpartum. The etiology and pathophysiology remain uncertain, although recent observations strongly suggest the specific role of prolactin cleavage secondary to unbalanced peri/postpartum oxidative stress. PPCM is a […]

Peripartum Cardiomyopathy: A Systematic Review (Classification, Evaluation and Management of Cardiomyopathies) Part 2

Viral myocarditis The relationship between pregnancy and viral myocarditis was established in 1968 in pregnant mice (Farber & Glasgow, 1970). Myocarditis as a cause of PPCM in humans was first suggested by Gouley et al., who corroborated infection with enlarged hearts with focal areas of fibrosis and necrosis (Gouley et al., 1937). Since then, several […]

Peripartum Cardiomyopathy: A Systematic Review (Classification, Evaluation and Management of Cardiomyopathies) Part 3

Management of peripartum cardiomyopathy When considering treatment during the peripartum period, a multidisciplinary approach is needed. Involvement of a maternal-fetal medical team, including a cardiologist, obstetrician, anesthetist, intensivist, and neonatologist is imperative as earliest as possible after the diagnosis. The type of monitoring and care should be individualized to minimize maternal and fetal morbidity and […]

Cardiomyopathy Detection from Electrocardiogram Features (Classification, Evaluation and Management of Cardiomyopathies) Part 1

Introduction Cardiomyopathy refers to diseases of the heart muscle that becomes enlarged, thick, or rigid. These changes affect the electrical stability of the myocardial cells, which predisposes the heart to failure or arrhythmias. Cardiomyopathy in its two common forms, dilated and hypertrophic, implies enlargement of the atria. Therefore, computer intelligence techniques are proposed for the […]

Cardiomyopathy Detection from Electrocardiogram Features (Classification, Evaluation and Management of Cardiomyopathies) Part 2

Oppositional BBO Opposition-based learning (OBL) has been introduced as a method that can be used by Evolutionary Algorithms (EAs) to accelerate convergence speed by comparing the fitness of an individual to its opposite and retaining the fitter one in the population (Rahnamayan, Tizhoosh, & Salama, 2007; Tizhoosh, 2005). The "opposite" of an individual is defined […]

Cardiomyopathy Detection from Electrocardiogram Features (Classification, Evaluation and Management of Cardiomyopathies) Part 3

Clustering and pruning The appropriate number of clusters in the neuro-fuzzy system is equivalent to the number of middle-layer neurons p shown in Figure 1. Determination of the optimal number of fuzzy rules is equivalent to finding a suitable number of clusters for the given data set. This can also be performed using fuzzy c-means […]

Prevention of Sudden Cardiac Death in Patients with Cardiomyopathy (Classification, Evaluation and Management of Cardiomyopathies) Part 1

Introduction Sudden cardiac death (SCD) is a major public health issue with an estimated annual incidence of 300,000 – 400,000 cases per year. The ACC/AHA/ESC 2006 guidelines define SCD as "death from an unexpected circulatory arrest, usually due to a cardiac arrhythmia occurring within an hour of the onset of symptoms"(Zipes et al. 2006). Most […]

Prevention of Sudden Cardiac Death in Patients with Cardiomyopathy (Classification, Evaluation and Management of Cardiomyopathies) Part 2

Primary prevention of SCD in patients with non-ischemic cardiomyopathy The early trials examining the effects of ICD therapy compared to antiarrhythmic therapy in patients with non-ischemic cardiomyopathy (NICM) were small and not powered enough to show mortality benefit. The first trial is the Amiodarone versus Implantable Cardioverter Defibrillator Trial (AMIOVERT) which compared ICD therapy in […]

Prevention of Sudden Cardiac Death in Patients with Cardiomyopathy (Classification, Evaluation and Management of Cardiomyopathies) Part 3

Cardiac resynchronization therapy trials in patients with moderate to severe heart failure The Multicenter InSync Randomized Clinical Evaluation (MIRACLE) trial involved implanting a CRT only device (with biventricular pacing only, no Defibrillator component). Patients were randomized if they had an LVEF < 35% and NYHA functional class III or IV heart failure despite optimal medical […]

Prevention of Sudden Cardiac Death in Patients with Cardiomyopathy (Classification, Evaluation and Management of Cardiomyopathies) Part 4

Defibrillator shocks, their impact on quality of life and prognosis Impact of defibrillator shocks on quality of life From all the studies presented earlier, it is clear that ICD therapy prevents sudden cardiac death. However, ICD shocks can be painful and have been shown to affect the quality of life in both primary and secondary […]

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