The Quest for New Approaches in Myocarditis and Inflammatory Cardiomyopathy

Stephane Heymans, Urs Eriksson, Jukka Lehtonen, Leslie T. Cooper

Research output: Contribution to journalReview article

70 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2348-2364
Number of pages17
JournalJournal of the American College of Cardiology
Volume68
Issue number21
DOIs
StatePublished - Nov 29 2016

Keywords

  • heart failure
  • inflammasomes
  • macrophages
  • microRNAs
  • sarcoidosis
  • t-lymphocyte subsets
  • viral infection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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