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- Tsung O Cheng, MDa
I enjoyed reading the recent article on a standardized definition of ischemic cardiomyopathy by Felker et al. (1). However, I was somewhat surprised by the fact that the investigators did not make any reference to the origin of the term “ischemic cardiomyopathy.” It was George Burch and associates (2)who in 1970 coined the term “ischemic cardiomyopathy,” which was quite provocative as well as controversial at the time.
Actually, the concept of ischemic cardiomyopathy dated back one year earlier when Raftery et al. (3)in England suggested a cause-and-effect relationship between coronary artery disease and congestive cardiomyopathy. But the term “ischemic cardiomyopathy” was introduced and popularized a year later by Burch et al. in New Orleans (2). They insisted that “The entity, therefore, should be accepted and recognized in view of the vast similarities to the other cardiomyopathies” (2). They emphasized that “ischemic cardiomyopathy is a true cardiomyopathy” (2).
There have been many systems of classification of cardiomyopathy ever since its original description by Brigden in 1957 (4). The World Health Organization (5)in 1981 classified cardiomyopathy into hypertrophic, dilated and restrictive types. But from a practical point of view a more useful classification is an etiologic one to distinguish between ischemic and non-ischemic varieties, because the prognosis is quite different. As Felker and associates (1)mentioned, angiographically diagnosed ischemic cardiomyopathy with heart failure is associated with a shorter survival than is non-ischemic cardiomyopathy with heart failure.
We are indebted to Burch et al. (2)for their foresight in introducing and conceptualizing the term “ischemic cardiomyopathy” 32 years before its validation by the Duke Databank (1). As Burch and associates so aptly stated in 1970, “Early recognition of coronary artery disease is important so that vigorous and prompt introduction of all measures available can be instituted to improve the coronary circulation and prevent the development of muscle damage or ischemic cardiomyopathy” (2).
- American College of Cardiology Foundation
- Felker G.M,
- Shaw L.K,
- O’Connor C.M
- Brigden W
- Brandenburg R.O,
- Chazov E,
- Cherian G,
- et al.