Position statement of Polish Cardiac Society experts on cardiomyopathy
Katarzyna Mizia-Stec1, Paweł Burchardt2,3, Łukasz Mazurkiewicz4
11st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Insights
Cardiomyopathies (CMs) are diverse heart muscle diseases requiring genetic and phenotypic evaluation for effective management. Early, multidisciplinary care models are crucial for improving patient outcomes and diagnosis, particularly in regions like Poland.
Area of Science:
- Cardiology
- Genetics
- Internal Medicine
Background:
- Cardiomyopathies (CMs) encompass a wide spectrum of genetic and acquired heart muscle diseases.
- Classification relies on phenotypic characteristics, but identifying the underlying etiology, often genetic, is vital for clinical management.
- Geographical and ethnic variations in genetic variant distribution necessitate localized data.
Purpose of the Study:
- To review the classification, diagnosis, and management of cardiomyopathies.
- To highlight the need for early detection and effective treatment strategies.
- To propose the development of a diagnostic and therapeutic model for Polish patients based on European examples.
Main Methods:
- Review of existing literature on cardiomyopathy classification and management.
- Analysis of phenotypic characteristics and diagnostic approaches, including imaging and genetic testing.
- Examination of systemic care models in European countries (France, Spain) for potential adaptation.
Main Results:
- Cardiomyopathies present with diverse causes and phenotypes, impacting diagnosis and treatment.
- Late diagnosis is common due to complex presentation and limited diagnostic test availability.
- Multidisciplinary care structures are essential for optimizing patient management.
Conclusions:
- Effective management of cardiomyopathies requires a personalized, expert, and coordinated approach.
- Establishing multidisciplinary teams is crucial for improving patient care.
- Adapting European care models could facilitate earlier detection and treatment of CMs in Poland.
Abstract:
Cardiomyopathies (CMs) are a very broad group of diseases, including genetically determined and acquired, and their classification is based on phenotypic characteristics. There is always a need to search for the etiology (often also to try to identify the genetic cause), which may determine the appropriate choice of clinical management. The geographical distribution of genetic variants varies as does the prevalence across populations, ethnic groups, regions, and countries. The most reliable data on the distribution of individual genetic variants come from developed countries. The phenotypic classification includes 5 main types of CM, i.e., dilated CM, hypertrophic, restrictive, arrhythmogenic right ventricular CM, and non-dilated left ventricular (LV) CM. Individual CMs are characterized by a variety of causes and different phenotypic pictures, which affect their presentation, diagnosis, and response to treatment. Within each type of CM, there are both familial and sporadic (acquired) forms. The complex presentation of CM, as well as the limited availability of screening and diagnostic tests, causes CMs to be diagnosed late, often at an advanced stage of the disease. Therapeutic management of CM is strictly determined by its type and clinical picture. Diagnostics include the assessment of symptoms, the results of imaging and genetic tests, as well as morphological, functional, and often histological assessment. This allows for personalized and dedicated clinical management. To optimize thediagnosis, treatment, and care of patients with CMs, an individualized, expert, systemic, coordinated, and often multidisciplinary structure of care is necessary. Hence, it is important to create multidisciplinary teams for CM management. We present examples of existing systemic solutions for the care of CM patients in Europe (France and Spain). Not all of these options are available to patients in our country. This article presents issues related to CM and may be the basis for developing a diagnostic and therapeutic model allowing for earlier detection of CM in Polish patients and their effective treatment.
Related Concept Videos
Cardiomyopathy V: Interprofessional Care
Cardiomyopathy I: Introduction and Classification
Cardiomyopathy II: Dilated Cardiomyopathy
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Cardiomyopathy IV: Restrictive Cardiomyopathy
Cardiomyopathy VI: Nursing Management


