CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
AFRICA
71
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…continued from page 65
reference to the alternative classification scheme of the European
Society of Cardiology.
11
In the latter scheme, cardiomyopathy
is regarded as a structural and functional abnormality of the
myocardium that is not due to hypertension, coronary artery
disease, valvular heart disease, pericardial disease, or congenital
heart disease. Furthermore, cardiomyopathy is sub-classified
into familial/genetic or non-familial/non-genetic types.
I have found that the European Society of Cardiology
classification lends itself well to the clinical evaluation of
patients with unexplained heart failure in the African setting.
12,13
It would be of interest to know the opinion of the authors and
that of the Pan-African Society of Cardiology (as suggested
by the authors) on the utility of the European classification of
cardiomyopathy compared to the version of the American Heart
Association in the African environment.
Finally, the authors make a case for a new and unique
classification of myocardial disorders for Africa. It is not clear
why Africans should be an exception to other populations of the
world. We have shown previously that while the burden of disease
may be higher for certain forms of cardiomyopathy in Africa, the
pathophysiological features of the cardiomyopathies are likely
to be the same in all continental populations.
13,14
Therefore, the
aspiration of the Pan-African Society of Cardiology should
probably be to contribute to the development of a universal
classification of cardiomyopathy for all people in the world,
possibly under the auspices of the World Health Organisation or
the World Heart Federation.
BONGANI M MAYOSI, DPhil, FCP (SA), bongani.mayosi@
uct.ac.za
Department of Medicine, Old Groote Schuur Hospital, Cape
Town, South Africa
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