Myocarditis and dilated cardiomyopathy: an inflammatory link.
TLDR
Anti-viral and anti-inflammatory therapies should be developed for their potential to prevent or ameliorate dilated cardiomyopathy (DCM).Abstract:
Myocarditis is a complex disease because multiple pathogenetic mechanisms play a role. While these mechanisms appear to act in a chronological cascade, they undoubtedly overlap in some cases, rendering diagnosis and treatment difficult. Ultimately, dilated cardiomyopathy (DCM) may result. A multitude of still-circumstantial evidence points to a major role of viral myocarditis in the etiology of DCM. The common presence of viral genetic material and viral proteins in the myocardium of patients with DCM provides the most compelling evidence, but proof of causality is still lacking. Nevertheless, because of the striking increase in heart failure prevalence in recent years, anti-viral and anti-inflammatory therapies should be developed for their potential to prevent or ameliorate DCM.read more
Citations
More filters
Journal ArticleDOI
Predictors of Outcome in Patients With Suspected Myocarditis
Ingrid Kindermann,Michael Kindermann,Reinhard Kandolf,Karin Klingel,Burkhard Bültmann,Thomas Müller,Angelika Lindinger,Michael Böhm +7 more
TL;DR: For patients with suspected myocarditis, advanced New York Heart Association functional class, immunohistological signs of inflammation, and lack of β-blocker therapy, but not histology (positive Dallas criteria) or viral genome detection, are related to poor outcome.
Journal ArticleDOI
Acute viral myocarditis
TL;DR: A general diagnostic approach is proposed, focuses on the viral aetiology and associated autoimmune processes, and reviews treatment options for patients with acute viral myocarditis.
Journal ArticleDOI
Inflammation as a therapeutic target in heart failure? A scientific statement from the Translational Research Committee of the Heart Failure Association of the European Society of Cardiology
Stephane Heymans,Emilio Hirsch,Stefan D. Anker,Pal Aukrust,Jean-Luc Balligand,Jan Willem Cohen-Tervaert,Helmut Drexler,Gerasimos Filippatos,Stephan B. Felix,Lars Gullestad,Denise Hilfiker-Kleiner,Stefan Janssens,Roberto Latini,Gitte Neubauer,Walter Paulus,Burkert Pieske,Piotr Ponikowski,Blanche Schroen,Heinz-Peter Schultheiss,Carsten Tschöpe,Marc van Bilsen,Faiez Zannad,John J.V. McMurray,Ajay M. Shah +23 more
TL;DR: This consensus document represents the outcome of the expert workshop on inflammation in heart failure and defines key research questions that still need to be addressed as well as considering the requirements for future clinical trials in this area.
Journal ArticleDOI
The management of myocarditis
Heinz-Peter Schultheiss,Heinz-Peter Schultheiss,Uwe Kühl,Uwe Kühl,Leslie T. Cooper,Leslie T. Cooper +5 more
TL;DR: In this paper, a review aims to help bridge the widening gap between recent mechanistic insights, which are largely derived from animal models, and their potential impact on disease burden, and illustrate the pathogenetic mechanisms that are prime targets for novel therapeutic interventions.
Journal ArticleDOI
CMR Sensitivity Varies With Clinical Presentation and Extent of Cell Necrosis in Biopsy-Proven Acute Myocarditis
Marco Francone,Cristina Chimenti,Nicola Galea,Fernanda Scopelliti,Romina Verardo,Roberto Galea,Iacopo Carbone,Carlo Catalano,Francesco Fedele,Andrea Frustaci +9 more
TL;DR: In acute myocarditis, CMR sensitivity is high for infarct-like, low for cardiomyopathic, and very low for arrhythmic clinical presentation; it correlates with the extent of cell necrosis-promoting expansion of interstitial space.
References
More filters
Journal ArticleDOI
Long-term Trends in the Incidence of and Survival With Heart Failure
Daniel Levy,Satish Kenchaiah,Martin G. Larson,Emelia J. Benjamin,Michelle J. Kupka,Kalon K.L. Ho,Joanne M. Murabito,Ramachandran S. Vasan +7 more
TL;DR: Over the past 50 years, the incidence ofheart failure has declined among women but not among men, whereas survival after the onset of heart failure has improved in both sexes.
Journal ArticleDOI
A clinical trial of immunosuppressive therapy for myocarditis
Jay W. Mason,John B. O'Connell,Ahvie Herskowitz,Noel R. Rose,Bruce M. McManus,Margaret E. Billingham,Thomas E. Moon +6 more
TL;DR: The results do not support routine treatment of myocarditis with immunosuppressive drugs, but long-term mortality was high and patients with a vigorous inflammatory response had less severe disease.
Journal ArticleDOI
Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis.
Robert E. Mccarthy,John P. Boehmer,Ralph H. Hruban,Grover M. Hutchins,Edward K. Kasper,Joshua M. Hare,Kenneth L. Baughman +6 more
TL;DR: Fulminant myocarditis is a distinct clinical entity with an excellent long-term prognosis and Aggressive hemodynamic support is warranted for patients with this condition.
Journal ArticleDOI
Detection of coxsackie-b-virus-specific rna sequences in myocardial biopsy samples from patients with myocarditis and dilated cardiomyopathy
TL;DR: Positive hybridisation signals, quantified by densitometry, were obtained with 9 of 17 samples from patients with histological evidence of active or healing myocarditis or dilated cardiomyopathy with inflammatory changes, and no Coxsackie-B-virus-specific sequences were detected in 4 samples from Patients in whom a viral aetiology was unlikely and the histological diagnosis was negative for myocardritis.
Journal ArticleDOI
From Myocarditis to Cardiomyopathy: Mechanisms of Inflammation and Cell Death Learning From the Past for the Future
TL;DR: The rather discouraging results obtained to date with immunosuppressive agents in the treatment of viral myocarditis indicated the importance of sparing neutralizing antibody production, which may be controlled by B cells, and raised the possibility of promising developments in immunomodulating therapy.