The Quest for New Approaches in Myocarditis and Inflammatory Cardiomyopathy

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:68

Review

Heymans, Stephane¹  Eriksson, Urs^2,3  Lehtonen, Jukka⁴  Cooper, Leslie T., Jr.⁵ 

[1] Maastricht Univ, Med Ctr, CARIM, Dept Cardiol, Maastricht, Netherlands

[2] GZO Reg Hlth Ctr, Wetzikon, Switzerland

[3] Univ Zurich, Ctr Mol Cardiol, Zurich, Switzerland

[4] Helsinki Univ Hosp, Helsinki, Finland

[5] Mayo Clin, Cardiovasc Dept, 4500 San Pablo Rd, Jacksonville, FL 32224 USA

关键词: heart failure;    inflammasomes;    macrophages;    microRNAs;    sarcoidosis;    t-lymphocyte subsets;    viral infection;   

DOI  :  10.1016/j.jacc.2016.09.937

来源: Elsevier

【 摘 要 】

Myocarditis is a diverse group of heart-specific immune processes classified by clinical and histopathological manifestations. Up to 40% of dilated cardiomyopathy is associated with inflammation or viral infection. Recent experimental studies revealed complex regulatory roles for several microribonucleic acids and T-cell and macrophage subtypes. Although the prevalence of myocarditis remained stable between 1990 and 2013 at about 22 per 100,000 people, overall mortality from cardiomyopathy and myocarditis has decreased since 2005. The diagnostic and prognostic value of cardiac magnetic resonance has increased with new, higher-sensitivity sequences. Positron emission tomography has emerged as a useful tool for diagnosis of cardiac sarcoidosis. The sensitivity of endomyocardial biopsy may be increased, especially in suspected sarcoidosis, by the use of electrogram guidance to target regions of abnormal signal. Investigational treatments on the basis of mechanistic advances are entering clinical trials. Revised management recommendations regarding athletic participation after acute myocarditis have heightened the importance of early diagnosis. (C) 2016 by the American College of Cardiology Foundation.

【 授权许可】

Free