Key result
Infantile hypertrophic cardiomyopathy features rapid progressive ventricular hypertrophy, likely influenced by derangements in the physiological transition and maturation of immature cardiomyocytes.
Why the study?
Pediatric HCM differs significantly from adult HCM, and derangement in physiological transition to the postnatal environment may influence immature cardiomyocyte maturation in early infancy.
This review highlights the distinct characteristics of infantile hypertrophic cardiomyopathy, emphasizing the role of cardiomyocyte maturation and environmental changes during transitional circulation.
Answers are grounded in this paper and cite their sources.
Infant mortality peak in early-onset pediatric HCM warrants close monitoring; leaves optimal management strategies open for prospective trials.
Hypertrophic cardiomyopathy (HCM) is characterized by ventricular wall hypertrophy with diastolic dysfunction. Pediatric HCM is distinguished from the adult in many aspects. Most children with HCM do not present clinically until the adolescent period, even when they are born with genetic mutations. Some infants with early-onset HCM present with massive progressive myocardial hypertrophy in the first few months of life, which is often fatal. The mortality of pediatric HCM peaks during the infantile and adolescent periods. These periods roughly correlate with children's growth spurt. Non-sarcomeric causes of HCM are more frequent in pediatric HCM, while sarcomeric causes are more common in adults. From the perspective of cardiac development, the fetal heart has immature cardiomyocytes, which are characterized by proliferation and exit their cell cycles with a decreased regenerative property after birth. In the perinatal period, there is a dynamic change in maturation of cardiomyocytes from immature to mature cells. Infants who are treated with steroids or born to mothers with diabetes or hyperthyroidism often show phenotypes of HCM, which gradually resolve. With remarkable advancement of molecular biology, understanding on maturation of cardiomyocytes has increased. Neonates undergo abrupt environmental changes during the transitional circulation, which is affected by oxygen, metabolic and hormonal fluctuations. Derangement in physiological transition to the normal postnatal environment may influence maturation of proliferative immature cardiomyocytes during early infancy. This article reviews updates of infantile HCM and recent molecular studies related to maturation of cardiomyocytes from the clinical point of view of identifying distinct characteristics of infantile HCM.
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Seok et al. (2021) conducted a review in Infantile Hypertrophic Cardiomyopathy. Infantile hypertrophic cardiomyopathy features rapid progressive ventricular hypertrophy, likely influenced by derangements in the physiological transition and maturation of immature cardiomyocytes.
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