Book Review

The Cardiomyopathic Heart

N Engl J Med 1994; 330:1911June 30, 1994

Article

The Cardiomyopathic Heart
Edited by Makoto Nagano, Nobuakira Takeda, and Naranjan S. Dhalla. 464 pp., illustrated. New York, Raven Press, 1993. $95. ISBN: 0-7817-0092-2

Congestive heart failure due to various forms of cardiomyopathy is a leading cause of cardiac morbidity and mortality. Despite recent clinical advances in the detection and treatment of cardiomyopathies, many fundamental questions remain unanswered. Progress in the field has been hampered most notably by the lack of clinically relevant experimental models of cardiomyopathy.

In May 1992, a symposium on cellular abnormalities associated with cardiomyopathies in animals was held in Tokyo, Japan, under the direction of Dr. Makoto Nagano. Now Nagano and colleagues have published the proceedings of this symposium as The Cardiomyopathic Heart. This book includes 44 original scientific contributions by 183 authors. The title of the symposium more accurately reflects the content and focus of this book than its current title.

The first half of the book focuses on detailed studies of the cardiomyopathic hamster and provides broad-ranging coverage of this topic. The topics of the chapters range from the mechanism of contractile dysfunction in this animal model to signal transduction and drug therapy. The second half of the book is less narrowly focused but covers topics ranging from Keshan disease to a new model of alcohol-induced cardiomyopathy and monocrotaline-induced pulmonary hypertension.

The strength of this book lies in its coverage of various animal models of cardiomyopathy. At the same time, however, the book lacks the focus required by investigators seeking detailed information on specific areas, and it falls short of providing an encyclopedic manual of cardiomyopathy in animals. As with most multiauthored books, there are obvious inconsistencies in the investigators' concepts and approaches. For example, Malhotra equates the Bio 53.58 strain of cardiomyopathic hamster with the Bio 14.6 strain in his evaluation of regulatory proteins. In contrast, Makino et al. used these two breeds to evaluate collagen expression in two diverse forms of cardiomyopathy.

Despite the recognition of the heart as an endocrine organ, there is a conspicuous absence of any chapters on the subject of natriuretic peptides or other cardiac autocrine or paracrine functions. The editors would have served the reader better by providing a unifying framework from which to view the cardiomyopathic heart. In its current form, the appeal of this book may be limited to a relatively small group of investigators.

Brooks S. Edwards, M.D.
Mayo Clinic, Rochester, MN 55905