NCIt related terms : Hypertrophic cardiomyopathy (HCM);
Alternative definition : KEGG: Hypertrophic cardiomyopathy (HCM) is a primary myocardial disorder with an autosomal
dominant pattern of inheritance that is characterized by hypertrophy of the left ventricles
with histological features of myocyte hypertrophy, myofibrillar disarray, and interstitial
fibrosis. HCM is one of the most common inherited cardiac disorders, with a prevalence
in young adults of 1 in 500. Hundreds of mutations in 11 genes that encode protein
constituents of the sarcomere have been identified in HCM. These mutations increase
the Ca2 sensitivity of cardiac myofilaments. Increased myofilament Ca2 sensitivity
is expected to increase the ATP utilization by actomyosin at submaximal Ca2 concentrations,
which might cause an imbalance in energy supply and demand in the heart under severe
stress. The inefficient use of ATP suggests that an inability to maintain normal ATP
levels could be the central abnormality. This theory might be supported by the discovery
of the role of a mutant PRKAG2 gene in HCM, which in active form acts as a central
sensing mechanism protecting cells from depletion of ATP supplies. The increase in
the myofilament Ca2 sensitivity well account for the diastolic dysfunction of model
animals as well as human patients of HCM. It has been widely proposed that left ventricular
hypertrophy is not a primary manifestation but develops as compensatory response to
sarcomere dysfunction.;