Myocarditis and inflammatory cardiomyopathy
Authors:
J. Krejčí
Authors place of work:
I. interní kardioangiologická klinika LF MU a FN u sv. Anny v Brně
; Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně
Published in the journal:
Kardiol Rev Int Med 2015, 17(4): 288-294
Category:
Cardiology Review
Summary
Myocarditis means an inflammation of the heart muscle, in the Czech Republic mostly of viral etiology. Infection may trigger immune and autoimmune mechanisms which contribute to the impairment of myocardial function. Myocarditis is considered the most common cause of dilated cardiomyopathy. Its typical manifestation is heart failure, chest pain, or arrhythmias. The most important noninvasive diagnostic method is magnetic resonance imaging; the gold standard of diagnostics is invasive examination – endomyocardial biopsy. A significant number of cases with impaired left ventricular systolic function recover spontaneously and therefore it is appropriate to postpone critical therapeutic decisions until approximately 3–6 months after diagnosis. Therapy is based on the standard heart failure treatment. Immunosuppressive or antimicrobial treatment may be considered in some cases according to endomyocardial biopsy results. The most severe cases may require device therapy.
Keywords:
myocarditis – inflammatory cardiomyopathy – clinical course – diagnostics – treatment
Zdroje
1. Richardson P, McKenna W, Bristow M et al. Report of the 1995 World Health Organisation/ International Society and Federation of Cardiology Task force on the definition and classification of cardiomyopathies. Circulation 1996; 93: 841–842.
2. Caforio AL, Pankuweit S, Arbustini E et al. Current state of knowledge on aetiology, diagnosis, management, and therapy ofmyocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34: 2636–2648. doi: 10.1093/ eurheartj/ eht210.
3. Malik LH, Singh GD, Amsterdam EA. The epidemiology, clinical manifestations, and management of chagas heart disease. Clin Cardiol 2015; 38: 565–569. doi: 10.1002/ clc.22421.
4. Palecek T, Kuchynka P, Hulinska D et al. Presence od Borrelia burgdorferi in endomyocardial biopsies in patients with new-onset unexplained dilated cardiomyopathy. Med Microbiol Immunol 2010; 199: 139–143. doi: 10.1007/ s00430-009-0141-6.
5. Kubanek M, Sramko M, Berenova D et al. Detection of Borrelia burgdorferi sensu lato in endomyocardial biopsy specimens in individuals with recent-onset dilated cardiomyopathy. Eur J Heart Fail 2012; 14: 588–596. doi: 10.1093/ eurjhf/ hfs027.
6. Cooper LT jr. Myocarditis. N Engl J Med 2009; 360: 1526–1538. doi: 10.1056/ NEJMra0800028.
7. Kindermann I, Barth C, Mahfoud F et al. Update on myocarditis. J Am Coll Cardiol 2012; 59: 779–792. doi: 10.1016/ j.jacc.2011.09.074.
8. Dennert R, Crijns HJ, Heymans S. Acute viral myocarditis. Eur Heart J 2008; 29: 2073–2082. doi: 10.1093/ eurheartj/ ehn296.
9. Schultheiss HP, Kühl U, Cooper LT. The management of myocarditis. Eur Heart J 2011; 32: 2616–2625. doi: 10.1093/ eurheartj/ ehr165.
10. D’Ambrosio A, Patti G, Manzoli A et al. The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: a review. Heart 2001; 85: 499–504.
11. Mason JW, O’Connell JB, Herskowitz A et al. A clinical trial of immunosuppressive therapy for myocarditis. The Myocarditis Treatment Trial Investigators. N Engl J Med 1995; 333: 269–275.
12. Kühl U, Pauschinger M, Noutsias M et al. High prevalence of viral genomes and multiple viral infections in the myocardium of adults with „idiopathic“ left ventricular dysfunction. Circulation 2005; 111: 887–893.
13. Krejci J, Poloczkova H, Hude P et al. Impact of inflammatory infiltration and viral genome presence in myocardium on the changes of echocardiographic parameters. Cor Vasa 2013; 55: e333–e340.
14. Kühl U. Antiviral treatment of myocarditis and acute dilated cardiomyopathy. Heart Fail Clin 2005; 1: 467–474.
15. Kuethe F, Lindner J, Matschke K et al. Prevalence of parvovirus B19 and human bocavirus DNA in the heart of patients with no evidence of dilated cardiomyopathy or myocarditis. Clin Infect Dis 2009; 49: 1660–1666. doi: 10.1086/ 648074.
16. Escher F, Modrow S, Sabi T et al. Parvovirus B19 profiles in patients with acute myocarditis and chronic dilated cardiomyopathy. Med Sci Monit 2008; 14: 589–597.
17. Caforio AL, Calabrese F, Angelini A et al. A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Eur Heart J 2007; 28: 1326–1333.
18. Kühl U, Lassner D, von Schlippenbach J et al. Interferon-beta improves survival in enterovirus-associated cardiomyopathy. J Am Coll Cardiol 2012; 60: 1295–1296.
19. Kindermann I, Kindermann M, Kandolf R et al. Predictors of outcome in patients with suspected myocarditis. Circulation 2008; 118: 639–648. doi: 10.1161/ CIRCULATIONAHA.108.769489.
20. McCarthy RE, Boehmer JP, Hruban RH et al. Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis. N Engl J Med 2000; 342: 690–695.
21. Krejci J, Hude P, Poloczkova H et al. Correlations of the changes in bioptic findings with echocardiographic, clinical and laboratory parameters in patients with inflammatory cardiomyopathy. Heart Vessels 2014. In press. Available from: http:/ / link.springer.com/ article/ 10.1007/ s00380-014-0618-0#.
22. Baccouche H, Mahrholdt H, Meinhardt G et al. Diagnostic synergy of non-invasive cardiovascular magnetic resonance and invasive endomyocardial biopsy in troponin-positive patients without coronary artery disease. Eur Heart J 2009; 30: 2869–2879. doi: 10.1093/ eurheartj/ ehp328.
23. Kuchynka P, Palecek T, Nemecek E et al. New therapeutic aspects on inflammatory cardiomyopathy. Curr Pharm Des 2015; 21: 459–465.
24. Friedrich MG, Sechtem U, Schulz-Menger J et. al.Cardiovascular magnetic resonance in myocarditis: a JACC White Paper. J Am Coll Cardiol 2009; 53: 1475–1487. doi: 10.1016/ j.jacc.2009.02.007.
25. Schumm J, Greulich S, Wagner A et al. Cardiovascular magnetic resonance risk stratification in patiens with clinically suspected myocarditis. J Cardiovasc Magn Reson 2014; 16: 14. doi: 10.1186/ 1532-429X-16-14.
26. Grün S, Schumm J, Greulich S et al. Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery. J Am Coll Cardiol 2012; 59: 1604–1615. doi: 10.1016/ j.jacc.2012.01.007.
27. Lauer B, Niederau C, Kühl U et al. Cardiac troponin T in patients with clinically suspected myokarditis. J Am Coll Cardiol 1997; 30: 1354–1359.
28. Mahfoud F, Gärtner B, Kindermann M et al. Virus serology in patients with suspected myocarditis: utility or futility? Eur Heart J 2011; 32: 897–903. doi: 10.1093/ eurheartj/ ehq493.
29. Heidecker B, Kittleson Mm, Kasper EK et al. Transcriptomic biomarkers for the accurate diagnosis of myocarditis. Circulation 2011; 123: 1174–1184. doi: 10.1161/ CIRCULATIONAHA.110.002857.
30. Cooper LT jr, Onuma OK, Sagar S et al. Genomic and proteomic analysis of myocarditis and dilated cardiomyopathy. Heart Fail Clin 2010; 6: 75–85. doi: 10.1016/ j.hfc.2009.08.012.
31. Corsten MF, Papageorgiou A, Verhesen W et al. miRNA profiling identifies miRNA-155 as an adverse mediator of cardiac injury and dysfunction during acute viral myocarditis. Circ Res 2012; 111: 415–425. doi: 10.1161/ CIRCRESAHA.112.267443.
32. Bao JL, Lin L. MiR-155 and miR-148a reduce cardiac injury by inhibiting NF-κB pathway during acute viral myocarditis. Eur Rev Med Pharmacol Sci 2014; 18: 2349–2356.
33. Kühl U, Rohde M, Lassner D et al. miRNA as activity marker in Parvo B19 associated heart disease. Herz 2012; 37: 637–643.
34. Kühl U, Lassner D, Dorner A et al. A Distinct subgroup of cardiomyopathy patients characterized by transcriptionally active cardiotropic erythrovirus and altered cardiac gene expression. Basic Res Cardiol 2013; 108: 372. doi: 10.1007/ s00395-013-0372-y.
35. Yilmaz A, Kindermann I, Kindermann M et al.Comparative evaluation of left and right ventricular endomyocardial biopsy: differences in complication rate and diagnostic performance. Circulation 2010; 122: 900–909. doi: 10.1161/ CIRCULATIONAHA.109.924167.
36. Chimenti C, Frustaci A. Contribution and risks of left ventricular endomyocardial biopsy in patients with cardiomyopathies: a retrospective study over a 28-year period. Circulation 2013; 128: 1531–1541. doi: 10.1161/ CIRCULATIONAHA.13.001414.
37. Aretz HT, Billingham ME, Edwards WD et al. Myocarditis. A histopathologic definition and classification. Am J Cardiovasc Pathol 1987; 1: 3–14.
38. Baughman KL. Diagnosis of myocarditis: Death of Dallas criteria. Circulation 2006; 113: 593–595.
39. Maisch B, Bultman B, Factor S et al. World Heart Federation consensus conference's definition on inflammatory cardiomyopathy (myocarditis): report from two expert committees on histology and viral cardiomyopathy. Heartbeat 1999; 4: 3–4.
40. Frustaci A, Russo MA, Chimenti C. Randomized study on the efficacy of immunosuppressive therapy in patients with virus-negative inflammatory cardiomyopathy: the TIMIC study. Eur Heart J 2009; 30: 1995–2002. doi: 10.1093/ eurheartj/ ehp249.
41. Wojnicz R, Nowalany-Kozielska E, Wojciechowska C et al. Randomized, placebo controled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy: two year follow-up results. Circulation 2001; 104: 39–45.
42. Bock CT, Klingel K, Kandolf R. Human parvovirus B19-associated myocarditis. N Engl J Med 2010; 362: 1248–1249. doi: 10.1056/ NEJMc0911362.
43. Bahk TJ, Daniels MD, Leon JS et al. Comparison of angiotension converting enzyme inhibition and angiotension II receptor blocade for prevention of experimental autoimmune myocarditis. Int J Cardiol 2008; 125: 85–93.
44. Saegusa S, Fei Y, Takahashi T et al. Oral administration of candesartan improves the survival of mice with viral myocarditis through modification of cardiac adiponectin expression. Cardiovasc Drug Ther 2007; 21: 155–160.
45. Yuan Z, Shioji K, Kihara Y et al. Cardioprotective effect of carvedilol on acute autoimmune myocarditis: antiinflammatory effects associated with antioxydant property. Am J Physiol Heart Circ Physiol 2004; 286: 83–90.
46. Pauschinger M, Rutschow S, Chandrasekharan Ket al. Carvedilol improves left ventricular function in murine coxsackievirus induced acute myocarditis association with reduced myocardial interleukin-1beta and MmP-8 expression and a modulated immune response. Eur J Heart Fail 2005; 7: 444–452.
47. Xiao J, Shimada M, Liu W et al. Antiinflammatory effect of eplerenone on viral myocarditis. Eur J Heart Fail 2009; 11: 349–353. doi: 10.1093/ eurjhf/ hfp023.
48. Cooper LT jr, Berry GJ, Shabetai R. Idiopathic giant-cell myocarditis-natural history and treatment. Multicentre giant cell myocarditis study group investigators. N Engl J Med 1997; 336: 1860–1866.
49. Cooper LT jr, Hare JM, Tazelaar HD et al. Usefulness of immunosuppression for giant cell myocarditis. Am J Cardiol 2008; 102: 1535–1539. doi: 10.1016/ j.amjcard.2008.07.041.
50. Kandolin R, Lehtonen J, Salmenkivi K et al. Diagnosis, treatment, and outcome of giant-cell myocarditis in the era of combined immunosuppression. Circ Heart Fail 2013; 6: 15–22. doi: 10.1161/ CIRCHEARTFAILURE.112.969261.
51. Kawano S, Kato J, Kawano N et al. Clinical features and outcomes of eosinophilic myocarditis patients treated with prednisolone at a single institution over a 27-year period. Intern Med 2011; 50: 975–981.
52. Yanagisawa T, Inomata T, Watanabe I et al. Clinical significance of corticosteroid therapy for eosinophilic myocarditis. Int Heart J 2011; 52: 110–113.
53. Blauwet LA, Cooper LT. Idiopathic giant cell myocarditis and cardiac sarcoidosis. Heart Fail Rev 2013; 18: 733–746. doi: 10.1007/ s10741-012-9358-3.
54. Frustaci A, Chimenti C, Calabrese F et al. Immunosuppressive therapy for active lymphocytic myocarditis. Virological and immunologic profile of responders versus nonresponders. Circulation 2003; 107: 857–886.
55. Palecek T, Krejci J, Pecen L et al. Czech Inflammatory Cardiomyopathy Immunosuppression Trial (CZECH-ICIT): Randomized, multicentric study comparing the effect of two regimens of combined immunosuppressive therapy in the treatment of inflammatory cardiomyopathy: The aims and design of the trial. Cor Vasa 2013; 55: 475–478.
56. Gullestad L, Aass H, Fjeld JG et al. Immunomodulating therapy with intravenous immunoglobulin in patients with chronic heart failure. Circulation 2001; 103: 220–225.
57. Dennert R, Velthuis S, Schalla S et al. Intravenous immunoglobulin therapy for patients with idiopathic cardiomyopathy and endomyocardial biopsy-proven high PVB19 viral load. Antivir Ther 2010; 15: 193–201.
58. McNamara DM, Holubkov R, Starling RC et al. Controlled trial of intravenous immune globulin in recent-onset dilated cardiomyopathy. Circulation 2001; 103: 2254–2259.
59. Staudt A, Hummel A, Ruppert A et al. Immunoadsorption in dilated cardiomyopathy: 6-month results from randomized study. Am Heart J 2006; 152: 712.e16.
60. Felix SB, Staudt A, Dörffer WV et al. Hemodynamic effects of immunoadsorption and subsequent immunoglobulin substitution in dilated cardiomyopathy: three-month results from a randomized study. J Am Coll Cardiol 2000; 35: 1590–1598.
61. Kühl U, Pauschinger M, Schwimmbeck PL et al. Interoferon – treatment eliminates cardiotropic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation 2003; 107: 2793–2798.
62. Zimmermann O, Rodewald C, Radermacher M et al. Interferon β-1b therapy in chronic viral dilated cardiomyopathy – is there a role for specific therapy? J Cardiac Fail 2010; 16: 348–356.
Štítky
Paediatric cardiology Internal medicine Cardiac surgery CardiologyČlánok vyšiel v časopise
Cardiology Review
2015 Číslo 4
Najčítanejšie v tomto čísle
- Pericarditis
- Myocarditis and inflammatory cardiomyopathy
- Adults with congenital heart diseases
- Infectious endocarditis – diagnostics and guidelines