Cardiomyopathies and Heart Failure

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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.