Myocardial Insufficiency
Cardiology section
Myocardial insufficiency, also known as heart failure, is a condition characterized by the heart's inability to pump blood effectively to meet the body's needs. This condition can result from various factors, including coronary artery disease, hypertension, myocardial infarction, valvular heart disease, and cardiomyopathies. It is a significant public health concern globally, affecting millions of people
of all ages. According to estimates from the Global Burden of Disease study, there were approximately 64 million cases of heart failure worldwide in 2019. The prevalence of myocardial insufficiency increases with age, particularly in developed countries. Early diagnosis and management are crucial for improving outcomes and reducing the burden of heart failure.
ABOUT MYOCARDIAL INSUFFICIENCY
UNDERSTANDING Myocardial Insufficiency
Long QT Syndrome (LQTS): Causes and Subtypes
In myocardial insufficiency, the heart's pumping function is compromised, leading to reduced cardiac output. This can result in inadequate blood flow to organs and tissues, causing symptoms such as fatigue, shortness of breath, and fluid retention (edema).
Most cases of myocardial insufficiency involve dysfunction of the left ventricle, the heart's main pumping chamber. This can lead to reduced ejection fraction (the percentage of blood ejected from the left ventricle with each heartbeat), a hallmark feature of heart failure with reduced ejection fraction (HFrEF). In some cases, myocardial insufficiency can also involve dysfunction of the right ventricle, particularly in conditions such as pulmonary hypertension or right-sided heart valve disease. Right ventricular dysfunction can contribute to symptoms such as peripheral edema and hepatic congestion. The body activates various compensatory mechanisms in response to myocardial insufficiency, including the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system. These mechanisms initially help maintain cardiac output but can become maladaptive over time, contributing to disease progression. Diagnosis of myocardial insufficiency typically involves a thorough clinical evaluation, including medical history, physical examination, and diagnostic tests such as echocardiography, electrocardiography (ECG), chest X-ray, and blood tests (including measurement of cardiac biomarkers such as B-type natriuretic peptide or NT-proBNP).
Overall, myocardial insufficiency is a complex and chronic condition that requires comprehensive management and ongoing medical care. Multidisciplinary approaches involving cardiologists, primary care physicians, nurses, and other healthcare professionals are essential for optimizing patient outcomes and quality of life. Key genes and genetic factors associated with myocardial insufficiency include:
Titin (TTN):
Beta-Myosin Heavy Chain (MYH7):
Ryanodine Receptor 2 (RYR2):
Phospholamban (PLN):
Natriuretic Peptide Precursor A (NPPA) and Natriuretic Peptide Precursor B (NPPB):
Renin-Angiotensin-Aldosterone System (RAAS) Genes:
These are just a few examples of the many genes and genetic factors that contribute to the pathogenesis of myocardial insufficiency.
The genetic basis of heart failure is complex and involves interactions between multiple genes, as well as environmental and lifestyle factors. Further research is needed to better understand the genetic mechanisms underlying heart failure and to develop more personalized approaches to diagnosis, risk stratification, and treatment.