Integrative Clinical Cardiology

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New Classification of Cardiomyopathy: Who are at Risk?

Galal Elkilany

Correspondence Address :

Galal Elkilany
Assistant Clinical Professor & Consultant of Cardiology
Gulf Medical University, UAE
E-mail: galal.elkilany@gmail.com

Received on: November 07, 2017, Accepted on: November 15, 2017, Published on: November 24, 2017

Citation: Galal Elkilany (2017). New Classification of Cardiomyopathy: Who are at Risk?

Copyright: 2017 Galal Elkilany. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Cardiomyopathies are diseases of heart muscle. Cardiomyopathies include a variety of myocardial disorders that manifest with various structural and functional phenotypes and are frequently genetic. Although some have defined cardiomyopathy to include myocardial disease caused by known cardiovascular causes (such as hypertension, ischemic heart disease, or valvular disease), current major society definitions of cardiomyopathy exclude heart disease secondary to such cardiovascular disorders [1].
In 1980, the World Health Organization (WHO) defined cardiomyopathies as "heart muscle diseases of unknown cause" to distinguish cardiomyopathy from cardiac dysfunction due to known cardiovascular entities such as hypertension, ischemic heart disease, or valvular disease [2].
As a result, the 1995 WHO/International Society and Federation of Cardiology (ISFC) Task Force on the Definition and Classification of the Cardiomyopathies expanded the classification to include all diseases affecting heart muscle and to take into consideration etiology as well as the dominant pathophysiology [3]. The new cardiomyopathy classification system "MOGE(S)" classification system easyto-use online web application tool for physicians. MOGE(S) can assist in the diagnosis and management of each individual cardiomyopathy patient by helping to classify his or her following five cardiomyopathic disorder attributes including: Morphofunctional characteristic or observable clinical traits, organ involvement, genetic inheritance pattern, etiological, or explicit genetic defect cause and stage of heart failure. The new system uses a more comprehensive, descriptive nomenclature to explain each individual patient's cardiomyopathy using a configuration of letters as a descriptive language or code to reveal additional details instantly for the medical community to understand exactly what type of cardiomyopathy disorder and genetic mutations a patient has. This new MOGE(S) code for each patient will allow for clearer and greater understanding of a patient's cardiomyopathy, easier communication among physicians, and even help us develop multi-centre and multinational registries for more future research into cardiomyopathies [4].
Importantly, the new MOGE(S) classification system will allow us to begin diagnosing early cardiomyopathy better, where disease is not present but genetic information and advanced cardiac imaging such as: Cardiac Magnetic Resonance Imaging (CMR), tissue Doppler echocardiography and deformation imaging shows evidence of increased risk of developing the condition in the pre-clinical stage of the disease, which will fuel clinical decision making for prevention of cardiomyopathy [5].
Finally, new emerging imaging modalities is of crucial importance to identify cardiomyopathy patients at risk for sudden cardiac death which can definitely stratifyl certain high risk patients for early intervention and implantation of Automated
Implantable Cardiovertor Defibrillator (AICD) to prevent sudden death [5,6].
Cardiac magnetic resonance imaging can identify fibous scar in hypertrophic cardiomyopathy which is a substrate for ventricular tachyarrhythmia and sudden death. In addition, Tissue Doppler Imaging (TDI) with strain and strain rate imaging recently used for early detection of cardiac dysfunction in a preclinical disease stage among such patients population [6,7].
1. Abelmann WH. Classification and natural history of primary myocardial disease. Prog Cardiovasc Dis. 1984;27(4):73-94.
2. Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies. Br Heart J. 1980;44(6):672-673.
3. Richardson P, McKenna W, Bristow M, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93(5):841-842.
4. Valentin Fuster. Mount Sinai Hospital's cardiologists contribute to the creation of newly proposed MOGE(S) Classification System for cardiomyopathy disorders. 2017 Icahn School of Medicine at Mount Sinai.
5. Elkilany, Galal Singh RB, Adeghate, et al. World Heart Journal; Hauppauge Vol. 9, Iss. 1, (2017): 51-62. Sudden cardiac Death mini review, World Heart Journal, 2017 volume 1.
6. Elkilany GE, Al-Qbandi MA, Sayed KA, Kabbash I. Dilated Cardiomyopathy in Children and Adults: What is New?. ScientificWorldJournal. 2008;8:762-775.
7. Galal E Nagib Elkilany. Diabetes Induced Cardiomyopathy[British Medical Journal], Volume 1, 2011 First Published in Heart Failure Meeting ESC [European Association of Heart failure], Nice, France 2009.
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