Clinical and basic science -Aspects of ventricular dysfunction-

Professor and Chief, Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA
Jeffrey A. Towbin

Background: Left ventricular (LV) dysfunction is commonly associated with signs and symptoms of congestive heart failure. The underlying causes of LV dysfunction include acquired disease such as myocarditis, as well as genetic causes (30-40%), metabolic and mitochondrial etiologies. Over the past decade, the use of molecular studies has allowed new understanding of etiology and mechanisms of LV dysfunction.
Results: To date, twelve genes for dilated cardiomyopathy and several genes for other forms of LV dysfunction have been identified. These genes encode proteins of the cytoskeleton and proteins which link the sarcomere and sarcolemma. In addition, a variety of viruses have been identified as significant etiologies including adenovirus, enterovirus, parvovirus and others. In some cases, there may be genetic susceptibility influencing the development of disease.
Conclusions: LV dysfunction is becoming well understood based on translational basic science studies. Novel therapies and better outcomes are possible in the near future.