Descripción general
- Las miocardiopatías son un grupo de afecciones con un fuerte trasfondo genético que dificultan estructuralmente que el corazón bombee sangre al resto del cuerpo debido a la debilidad de los músculos del corazón. Estas enfermedades afectan a personas de todas las edades y pueden provocar insuficiencia cardíaca y muerte cardíaca súbita. Si hay antecedentes familiares de miocardiopatía, se recomienda encarecidamente someterse a pruebas genéticas para conocer el riesgo familiar, el riesgo personal y las opciones de tratamiento. La mayoría de los tipos de miocardiopatías se heredan de manera dominante, lo que significa que una copia alterada del gen es suficiente para que la enfermedad se presente en un individuo. Los síntomas de la miocardiopatía son variables y estas enfermedades pueden presentarse de diferentes formas. Existen 5 tipos de miocardiopatías, siendo la miocardiopatía hipertrófica la más común:
-
Miocardiopatía hipertrófica (MCH)
-
Miocardiopatía dilatada (DCM)
-
Miocardiopatía restrictiva (RCM)
-
Miocardiopatía arritmogénica del ventrículo derecho (ARVC)
-
Miocardiopatía aislada no compactada del ventrículo izquierdo (LVNC).
-
- El panel de precisión de miocardiopatía Igenomix sirve como herramienta de diagnóstico y, en última instancia, conduce a un mejor tratamiento y pronóstico de la enfermedad. Proporciona un análisis completo de los genes involucrados en esta enfermedad utilizando secuenciación de próxima generación (NGS) para comprender completamente el espectro de genes relevantes.
Indicación
- El Panel de Precisión Miocardiopatía Igenomix está indicado en aquellos casos en los que exista una sospecha clínica de miocardiopatía con o sin las siguientes manifestaciones:
-
Dificultad para respirar
-
Fatiga
-
Arritmia (ritmo cardíaco anormal).
-
Antecedentes familiares de arritmia
-
Exploraciones anormales
-
Taquicardia ventricular
-
La fibrilación ventricular
-
Dolor de pecho
-
Mareo
-
Muerte cardíaca súbita en la familia
-
Utilidad clínica
La utilidad clínica de este panel es:
-
El diagnóstico genético y molecular para un diagnóstico clínico preciso de un paciente con antecedentes personales o familiares de miocardiopatía, canalopatía o muerte súbita cardíaca.
-
Inicio temprano del tratamiento con un equipo multidisciplinario para la colocación preventiva adecuada de ICD, marcapasos, terapia farmacológica o procedimientos intervencionistas.
-
Evaluación de riesgos y asesoramiento genético de familiares asintomáticos según modalidad hereditaria.
Genes y enfermedades
GENE |
OMIM DISEASES |
INHERITANCE* |
% GENE COVERAGE (20X) |
HGMD** |
AARS2 |
Combined Oxidative |
AR |
100 |
54 OF 54 |
ABCC9 |
Familial Atrial Fibrillation, |
AD |
100 |
51 OF 51 |
ACAD9 |
Acyl-CoAa Dehydrogenase Deficiency |
AR |
100 |
62 OF 62 |
ACADVL |
Acyl-CoA Dehydrogenase Deficiency, |
AR |
100 |
329 OF 329 |
ACTA1 |
Congenital Myopathy With |
AD,AR |
100 |
224 OF 224 |
ACTC1 |
Atrial Septal Defect, |
AD |
99.93 |
72 OF 74 |
ACTN2 |
Dilated Cardiomyopathy |
AD |
100 |
56 OF 56 |
AGL |
Glycogen Storage Disease III |
AR |
100 |
253 OF 253 |
ALMS1 |
Alstrom Syndrome |
AR |
99.92 |
302 OF 305 |
ALPK3 |
Familial Hypertrophic Cardiomyopathy |
AR |
97.29 |
7 OF 7 |
ANO5 |
Miyoshi Muscular Dystrophy, |
AD,AR |
99.78 |
171 OF 173 |
APOA1 |
Familial Visceral Amyloidosis, |
AD |
99.89 |
68 OF 70 |
ATP6 |
Leber Optic Atrophy , Neuropathy, |
MI |
NA |
NA |
ATP8 |
Kearns-Sayre Syndrome |
|
98.02 |
NA OF NA |
BAG3 |
Dilated Cardiomyopathy |
AD |
100 |
83 OF 85 |
BRAF |
Cardiofaciocutaneous Syndrome, |
AD |
100 |
80 OF 80 |
CACNA1C |
Brugada Syndrome, Timothy Syndrome, |
AD |
99.8 |
85 OF 85 |
CALR3 |
Hypertrophic Cardiomyopathy, |
|
100 |
5 OF 5 |
CAPN3 |
Limb-Girdle Muscular Dystrophy |
AD,AR |
100 |
503 OF 505 |
CASQ2 |
Catecholaminergic Polymorphic |
AD,AR |
100 |
39 OF 40 |
CBL |
Noonan Syndrome |
AD |
100 |
46 OF 47 |
CDH2 |
Familial Arrhythmogenic Right |
AD |
99.98 |
16 OF 16 |
CHRM2 |
Dilated Cardiomyopathy |
|
99.98 |
1 OF 1 |
COX15 |
Fatal Infantile Cardioencephalomyopathy, |
AR,MI |
100 |
5 OF 5 |
COX3 |
Leber Optic Atrophy , |
MI |
NA |
NA |
CPT2 |
Carnitine Palmitoyltransferase |
AD,AR |
99.99 |
116 OF 116 |
CRPPA |
Muscular Dystrophy- |
AR |
97.69 |
NA OF NA |
CRYAB |
Dilated Cardiomyopathy |
AD,AR |
100 |
30 OF 30 |
CSRP3 |
Dilated Cardiomyopathy, |
AD |
100 |
36 OF 36 |
CTNNA3 |
Familial Arrhythmogenic Right |
AD |
99.97 |
14 OF 17 |
CYTB |
Histiocytoid Cardiomyopathy |
MI |
98.8 |
NA OF NA |
DBH |
Dopamine Beta-Hydroxylase |
AR |
100 |
11 OF 11 |
DES |
Dilated Cardiomyopathy |
AD,AR |
99.97 |
133 OF 134 |
DMD |
Dilated Cardiomyopathy |
X,XR,G |
99.96 |
NA OF NA |
DNAJC19 |
Dilated Cardiomyopathy With Ataxia |
AR |
100 |
6 OF 6 |
DOLK |
Familial Isolated Dilated |
AR |
99.98 |
13 OF 13 |
DPM3 |
Congenital Disorder Of Glycosylation |
AR |
100 |
4 OF 4 |
DSC2 |
Familial Arrhythmogenic Right |
AD,AR |
100 |
123 OF 124 |
DSG2 |
Familial Arrhythmogenic Right |
AD |
99.38 |
167 OF 169 |
DSP |
Familial Arrhythmogenic Right |
AD,AR |
99.91 |
366 OF 369 |
DTNA |
Left Ventricular Noncompaction |
AD |
97 |
10 OF 10 |
DYSF |
Miyoshi Myopathy, Limb-Girdle |
AR |
100 |
604 OF 606 |
EEF1A2 |
Early Infantile |
AD |
100 |
14 OF 14 |
ELAC2 |
Combined Oxidative |
AR |
100 |
32 OF 32 |
EMD |
X-linked Emery-Dreifuss Muscular Dystrophy |
X,XR,G |
99.92 |
NA OF NA |
EPG5 |
Immunodeficiency With |
AR |
98.98 |
73 OF 73 |
ETFA |
Multiple Acyl-CoA Dehydrogenase |
AR |
92.33 |
32 OF 32 |
ETFB |
Multiple Acyl-CoA Dehydrogenase |
AR |
100 |
21 OF 21 |
ETFDH |
Multiple Acyl-CoA Dehydrogenase |
AR |
100 |
221 OF 222 |
EYA4 |
Dilated Cardiomyopathy |
AD |
100 |
32 OF 32 |
FBXL4 |
Mitochondrial DNA |
AR |
99.26 |
46 OF 51 |
FBXO32 |
Dilated Cardiomyopathy |
|
100 |
2 OF 2 |
FHL1 |
Reducing Body Myopathy, |
X,XR,XD,G |
99.98 |
NA OF NA |
FHOD3 |
Hypertrophic Cardiomyopathy |
|
99.95 |
35 OF 35 |
FKRP |
Muscular Dystrophy- |
AR |
99.9 |
157 OF 157 |
FKTN |
Dilated Cardiomyopathy, |
AR |
98 |
54 OF 56 |
FLNC |
Familial Hypertrophic Cardiomyopathy, |
AD |
100 |
185 OF 186 |
FOXRED1 |
Mitochondrial Complex I Deficiency, |
AR |
100 |
13 OF 13 |
GAA |
Glycogen Storage Disease II |
AR |
100 |
623 OF 624 |
GATA6 |
Atrial Septal Defect, |
AD,AR |
84.19 |
66 OF 84 |
GATAD1 |
Dilated Cardiomyopathy |
AR |
88.2 |
1 OF 1 |
GBE1 |
Glycogen Storage Disease IV, |
AR |
99.95 |
71 OF 74 |
GFM1 |
Combined Oxidative |
AR |
100 |
27 OF 27 |
GLA |
Fabry Disease |
X,XR,G |
98 |
NA OF NA |
GLB1 |
GM1-Gangliosidosis, |
AR |
100 |
242 OF 243 |
GMPPB |
Muscular Dystrophy-Dystroglycanopathy |
AR |
99.95 |
53 OF 53 |
GSK3B |
Usher Syndrome, Alzheimer Disease |
|
99.91 |
1 OF 1 |
GTPBP3 |
Combined Oxidative |
AR |
99.94 |
17 OF 17 |
HADHA |
Long-Chain 3-hydroxyacyl-CoA |
AR |
100 |
75 OF 75 |
HAND1 |
Hypoplastic Left Heart Syndrome |
|
99.89 |
9 OF 9 |
HCN4 |
Brugada Syndrome |
AD |
98.01 |
40 OF 41 |
HFE |
Alzheimer Disease, |
AD,AR |
100 |
55 OF 57 |
HRAS |
Costello Syndrome, |
AD |
100 |
34 OF 34 |
IDUA |
Hurler Syndrome, |
AR |
99.73 |
287 OF 292 |
ILK |
Dilated Cardiomyopathy |
|
100 |
14 OF 14 |
JPH2 |
Familial Hypertrophic Cardiomyopathy |
AD |
98.24 |
17 OF 17 |
JUP |
Familial Arrhythmogenic Right |
AD,AR |
100 |
56 OF 56 |
KLHL24 |
Epidermolysis Bullosa Simplex, Generalized, |
AD |
99.96 |
8 OF 8 |
KRAS |
Cardiofaciocutaneous Syndrome, |
AD |
100 |
38 OF 38 |
LAMA2 |
Congenital Merosin-Deficient |
AR |
100 |
363 OF 377 |
LAMP2 |
Danon Disease , Glycogen |
X,XD,G |
99.96 |
NA OF NA |
LARGE1 |
Muscular Dystrophy-Dystroglycanopathy |
AR |
100 |
NA OF NA |
LDB3 |
Dilated Cardiomyopathy, |
AD |
100 |
60 OF 60 |
LEMD2 |
Congenital Cataract, Juvenile |
AR |
93.48 |
3 OF 3 |
LMNA |
Dilated Cardiomyopathy, |
AD,AR |
100 |
619 OF 620 |
LMOD2 |
Familial Hypertrophic Cardiomyopathy |
|
99.37 |
1 OF 1 |
LRRC10 |
Dilated Cardiomyopathy |
|
100 |
5 OF 5 |
LZTR1 |
Noonan Syndrome |
AD |
99.99 |
136 OF 136 |
MAP2K1 |
Cardiofaciocutaneous Syndrome, |
AD |
100 |
31 OF 31 |
MAP2K2 |
Cardiofaciocutaneous Syndrome, |
AD |
100 |
37 OF 37 |
MAP3K8 |
Lung Cancer, Rheumatoid Arthritis |
AD |
99.91 |
1 OF 1 |
MLYCD |
Malonyl-CoA Decarboxylase Deficiency |
AR |
93.84 |
32 OF 40 |
MRAS |
Noonan Syndrome |
AD |
100 |
3 OF 3 |
MT-CO1 |
Mitochondrial Complex IV Deficiency |
|
97.64 |
NA OF NA |
MT-CO2 |
Mitochondrial Complex IV Deficiency |
|
99.19 |
NA OF NA |
MT-ND1 |
Mitochondrial Myopathy |
|
98.8 |
NA OF NA |
MTO1 |
Combined Oxidative |
AR |
99.83 |
31 OF 31 |
MYBPC3 |
Familial Hypertrophic Cardiomyopathy, |
AD,AR |
99.95 |
1072 OF 1079 |
MYBPHL |
Dilated Cardiomyopathy |
|
100 |
3 OF 3 |
MYH6 |
Atrial Septal Defect, |
AD |
99.94 |
140 OF 142 |
MYH7 |
Dilated Cardiomyopathy, |
AD,AR |
99.95 |
1053 OF 1054 |
MYL2 |
Familial Hypertrophic Cardiomyopathy, |
AD |
100 |
67 OF 67 |
MYL3 |
Familial Hypertrophic Cardiomyopathy |
AD,AR |
100 |
42 OF 42 |
MYL4 |
Familial Atrial Fibrillation |
AD |
100 |
2 OF 2 |
MYLK3 |
Hypoplastic Right Heart Syndrome, |
|
99.83 |
3 OF 3 |
MYOT |
Myopathy Spheroid Body Myotilinopathy, |
AD |
100 |
17 OF 17 |
MYPN |
Dilated Cardiomyopathy, |
AD,AR |
99.94 |
49 OF 49 |
MYRF |
Cardiac-Urogenital Syndrome |
AD |
99.83 |
27 OF 27 |
ND2 |
Leber Optic Atrophy , |
MI |
85.56 |
NA OF NA |
ND3 |
Isolated Complex I Deficiency, |
|
99.99 |
NA OF NA |
ND4 |
Leber Optic Atrophy, |
MI |
NA |
NA |
ND4L |
Leber Optic Atrophy, |
MI |
99.83 |
NA OF NA |
ND5 |
Leber Optic Atrophy, |
MI |
99.89 |
NA OF NA |
ND6 |
Leber Optic Atrophy , |
MI |
100 |
NA OF NA |
NDUFAF2 |
Mitochondrial Complex I Deficiency, |
AR |
99.39 |
6 OF 6 |
NEXN |
Dilated Cardiomyopathy, |
AD |
99.7 |
44 OF 45 |
NF1 |
Neurofibromatosis-Noonan |
AD |
97.97 |
3082 OF 3166 |
NKX2-5 |
Atrial Septal Defect With Or |
AD,AR |
99.98 |
112 OF 116 |
NONO |
Macrocephaly-Intellectual |
X,XR,G |
99.59 |
NA OF NA |
NRAP |
Myofibrillar Myopathy, |
|
99.98 |
7 OF 7 |
NRAS |
Noonan Syndrome, |
AD |
100 |
15 OF 15 |
PCCA |
Propionic Acidemia |
AR |
100 |
137 OF 137 |
PCCB |
Propionic Acidemia |
AR |
99.95 |
136 OF 138 |
PKP2 |
Familial Arrhythmogenic Right |
AD |
100 |
306 OF 307 |
PLEC |
Epidermolysis Bullosa Simplex With |
AD,AR |
99.98 |
113 OF 113 |
PLEKHM2 |
Leukodystrophy and Acquired |
|
99.94 |
1 OF 1 |
PLN |
Dilated Cardiomyopathy, |
AD |
100 |
26 OF 33 |
PNPLA2 |
Neutral Lipid Storage |
AR |
100 |
53 OF 53 |
PPA2 |
Sudden Cardiac Failure, |
AR |
99.95 |
9 OF 9 |
PPCS |
Dilated Cardiomyopathy |
AR |
98.95 |
4 OF 4 |
PPP1CB |
Noonan Syndrome-Like Disorder |
AD |
99.87 |
12 OF 12 |
PRDM16 |
Left Ventricular Noncompaction, |
AD |
98.81 |
20 OF 20 |
PRKAG2 |
Familial Hypertrophic Cardiomyopathy, |
AD |
99.98 |
61 OF 61 |
PTPN11 |
Leopard Syndrome, |
AD |
100 |
150 OF 151 |
QRSL1 |
Combined Oxidative Phosphorylation |
AR |
99.91 |
6 OF 7 |
RAF1 |
Dilated Cardiomyopathy, |
AD |
100 |
64 OF 64 |
RASA1 |
Capillary Malformation-Arteriovenous |
AD |
99.56 |
169 OF 169 |
RASA2 |
Noonan Syndrome |
|
99.82 |
5 OF 5 |
RBCK1 |
Polyglucosan Body Myopathy, |
AR |
100 |
13 OF 13 |
RBM20 |
Dilated Cardiomyopathy |
AD |
96.83 |
73 OF 75 |
RIT1 |
Noonan Syndrome 8 |
AD |
99.85 |
27 OF 27 |
RRAS |
Noonan Syndrome |
|
95.86 |
3 OF 3 |
RYR2 |
Familial Arrhythmogenic Right |
AD |
99.2 |
466 OF 472 |
SCN5A |
Familal Atrial Fibrillation, |
AD,AR,MU |
99.45 |
929 OF 942 |
SCNN1B |
Bronchiectasis, Liddle Syndrome, |
AD,AR |
100 |
56 OF 56 |
SCNN1G |
Bronchiectasis With Or Without |
AD,AR |
100 |
28 OF 28 |
SCO1 |
Mitochondrial Complex IV Deficiency |
AR,MI |
100 |
6 OF 6 |
SCO2 |
Fatal Infantile |
AD,AR |
100 |
38 OF 38 |
SDHA |
Dilated Cardiomyopathy, |
AD,AR,MI |
99.98 |
103 OF 103 |
SGCA |
Limb-Girdle Muscular Dystrophy, |
AR |
100 |
119 OF 119 |
SGCB |
Limb-Girdle Muscular Dystrophy, |
AR |
98.36 |
55 OF 65 |
SGCD |
Dilated Cardiomyopathy, |
AD,AR |
99.89 |
31 OF 32 |
SGCG |
Limb-Girdle Muscular Dystrophy, |
AR |
100 |
53 OF 55 |
SHOC2 |
Noonan Syndrome-Like Disorder |
AD |
99.98 |
8 OF 8 |
SLC22A5 |
Systemic Primary Carnitine |
AR |
100 |
161 OF 162 |
SLC25A20 |
Carnitine-Acylcarnitine Translocase Deficiency |
AR |
100 |
39 OF 39 |
SLC25A4 |
Mitochondrial DNA Depletion |
AD,AR |
99.84 |
16 OF 16 |
SMCHD1 |
Bosma Arhinia Microphthalmia |
AD,MU,D |
99.64 |
131 OF 137 |
SOS1 |
Noonan Syndrome, |
AD |
100 |
103 OF 104 |
SOS2 |
Noonan Syndrome |
AD |
99.48 |
6 OF 7 |
SPEG |
Centronuclear Myopathy |
AR |
99.26 |
17 OF 17 |
SPRED1 |
Legius Syndrome |
AD |
100 |
84 OF 84 |
TAB2 |
Congenital Heart Defects, |
AD |
99 |
13 OF 13 |
TAZ |
Barth Syndrome, Familial |
X,XR,G |
100 |
NA OF NA |
TBX20 |
Atrial Septal Defect |
AD |
99.98 |
33 OF 34 |
TBX5 |
Holt-Oram Syndrome |
AD |
100 |
143 OF 152 |
TCAP |
Familial Hypertrophic Cardiomyopathy, |
AD,AR |
100 |
33 OF 33 |
TGFB3 |
Familial Arrhythmogenic |
AD |
100 |
34 OF 35 |
TMEM43 |
Familial Arrhythmogenic |
AD |
99.98 |
26 OF 26 |
TMEM70 |
Mitochondrial Complex V |
AR |
100 |
22 OF 24 |
TNNC1 |
Dilated Cardiomyopathy, |
AD |
100 |
28 OF 28 |
TNNI3 |
Dilated Cardiomyopathy, |
AD,AR |
100 |
139 OF 139 |
TNNI3K |
Cardiac Conduction Disease |
AD |
99.97 |
4 OF 4 |
TNNT2 |
Dilated Cardiomyopathy, |
AD |
100 |
169 OF 169 |
TOR1AIP1 |
Limb-Girdle Muscular Dystrophy |
AR |
97.5 |
5 OF 6 |
TPM1 |
Dilated Cardiomyopathy, |
AD |
100 |
108 OF 108 |
TRIM32 |
Bardet-Biedl Syndrome, |
AR |
100 |
17 OF 17 |
TRNC |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNE |
Mitochondrial Myopathy |
|
NA |
NA |
TRNF |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNH |
MELAS, MERRF |
|
NA |
NA |
TRNI |
Myoclonic Epilepsy Associated |
MI |
NA |
NA |
TRNK |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNL1 |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNL2 |
Mitochondrial DNA-Related |
|
NA |
NA |
TRNN |
Mitochondrial Complex IV Deficiency, |
AR,MI |
NA |
NA |
TRNQ |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNS1 |
Mitochondrial Complex IV Deficiency , |
AR,MI |
NA |
NA |
TRNS2 |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNT |
Lethal Infantile Mitochondrial |
MI |
NA |
NA |
TRNV |
Mitochondrial Myopathy, |
MI |
NA |
NA |
TRNW |
Mitochondrial Myopathy, |
AR,MI |
NA |
NA |
TTN |
Dilated Cardiomyopathy, |
AD,AR |
97.93 |
1153 OF 1219 |
TTR |
Amyloidosis VII, Carpal Tunnel Syndrome |
AD |
100 |
195 OF 196 |
VCL |
Dilated Cardiomyopathy, |
AD |
99.99 |
36 OF 37 |
VCP |
Amyotrophic Lateral Sclerosis With |
AD |
100 |
68 OF 69 |
VPS13A |
Choreoacanthocytosis |
AR |
99.37 |
120 OF 122 |
XK |
Mcleod Syndrome |
X,G |
99.97 |
NA OF NA |
* Herencia: AD: Autosómico Dominante; AR: autosómico recesivo; X: ligado a X; XLR: recesivo vinculado a X; Mi: mitocondrial; Mu: multifactorial; G: herencia gonosomal; D: herencia digénica
** HGMD: número de mutaciones clínicamente relevantes según HGMD
Referencias
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019;March 17
Burke, M. A., Cook, S. A., Seidman, J. G., & Seidman, C. E. (2016). Clinical and Mechanistic Insights Into the Genetics of Cardiomyopathy. Journal of the American College of Cardiology, 68(25), 2871–2886. https://doi.org/10.1016/j.jacc.2016.08.079
Hershberger, R. E., Givertz, M. M., Ho, C. Y., Judge, D. P., Kantor, P. F., McBride, K. L., Morales, A., Taylor, M., Vatta, M., Ware, S. M., & ACMG Professional Practice and Guidelines Committee (2018). Genetic evaluation of cardiomyopathy: a clinical practice resource of the American College of Medical Genetics and Genomics (ACMG). Genetics in medicine : official journal of the American College of Medical Genetics, 20(9), 899–909. https://doi.org/10.1038/s41436-018-0039-z
Hershberger, R. E., Givertz, M. M., Ho, C. Y., Judge, D. P., Kantor, P. F., McBride, K. L., Morales, A., Taylor, M., Vatta, M., & Ware, S. M. (2018). Genetic Evaluation of Cardiomyopathy-A Heart Failure Society of America Practice Guideline. Journal of cardiac failure, 24(5), 281–302. https://doi.org/10.1016/j.cardfail.2018.03.004
Corrado, D., Basso, C., & Judge, D. P. (2017). Arrhythmogenic Cardiomyopathy. Circulation research, 121(7), 784–802. https://doi.org/10.1161/CIRCRESAHA.117.309345
Correction to: 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. (2020). Circulation, 142(25). doi: 10.1161/cir.0000000000000945
McKenna, W. J., Maron, B. J., & Thiene, G. (2017). Classification, Epidemiology, and Global Burden of Cardiomyopathies. Circulation research, 121(7), 722–730. https://doi.org/10.1161/CIRCRESAHA.117.309711