PROBING THE HEART OF CARDIOMYOPATHIES

Current knowledge of aetiopathogenesis of various forms of human cardi omyopathy is reviewed in this article. There are overwhelming evidence s to suggest a pathogenetic link between persistent viral infection, i nduction of autoimmunity (influenced by immune response determinants i n the HLA region) and alteration in the differentiated functions of th e myocardium in dilated cardiomyopathy. Genetic studies have identifie d specific defects in patients with hypertrophic cardiomyopathy but th e cellular basis of the disease remains unresolved. Endomyocardial dis eases associated with hypereosinophilic syndrome and endomyocardial fi brosis of the tropics appear to be two separate entities. A unifying l ink among endomyocardial fibrosis of diverse causes could be the unifo rm response of the 'cardiac tissue to injuries of heterogenous nature. Application of microtechniques to endomyocardial biopsy promises defi nitive information on aetiopathogenesis of cardiomyopathies.