Cardiomyopathies - The special entity of myocarditis and inflammatory cardiomyopathy

Escher, Felicitas; Kühl, Uwe; Laßner, Dirk; Schultheiss, Heinz‐Peter

doi:10.29328/journal.jccm.1001041

Cited by 4 publications

(4 citation statements)

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“…За етіопатогенетичними механізмами, клінічними проявами, особливостями перебігу та наслідками міокардити можна розцінювати як неоднорідну групу захворювань, в основі яких лежить загальна гістологічна ознаказапальний процес у міокарді. Проте, незважаючи на об'єднуючий запальний процес тяжкість перебігу і наслідки захворювання важко передбачити і спрогнозувати, оскільки в 40-60% випадків дисфункція міокарда може відновлюватись спонтанно [4,8], в інших випадках розвивається дилятаційна кардіоміопатія (ДКМП) і хворі часто потребують трансплантації серця [1,2,7,15]. У хворих на міокардит, який підтверджений ендоміокардіальною біопсією, 5-річне виживання без трансплантації серця, за даними ряду спостережень, становить 55-80 %.…”

Section: матеріали та методиunclassified

“…заклітинного матриксу та розвиток фіброзування міокарду. Активність і поширеність запального процесу при міокардиті тісно пов'язане з тяжкістю захворювання, але навіть при невиражених клінічних проявах міокардиту тип запальної відповіді організму, її ступінь і тривалість визначають результат захворюваннярозвиток фіброзу, дилатаційної кардіоміопатії, серцевої недостатності, аритмії чи розрішення міокардиту без ускладнень [4,7,8].…”

Section: матеріали та методиunclassified

“…У іншої частини хворих, приблизно у 25% пацієнтів спостерігається розвиток хронічної систолічної дисфункції, тоді як решта прогресує до кінцевої стадії кардіоміопатії, що призводить до необхідності трансплантації серця або смерті [10]. За даними авторів до 52% хворих страждає на ДКМП через декількох років після перенесеного, гістологічно підтвердженого міокардиту [4,8].…”

Section: матеріали та методиunclassified

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Clinical, laboratory changes and fibroblast growth factor in patients with myocarditis

Myndziv¹,

Yarema²

2022

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. The relevance of the problem of diagnosis and treatment of myocarditis in the world and in Ukraine is growing. The prevalence of myocarditis is up to 20% of all non-coronary heart lesions. According to the results of the study of the sudden death causes in young people, the detection of inflammatory lesions of the myocardium varies in the range of 2-42%. The article analyzes the course of acute myocarditis of unknown etiology in 48 adult patients (31 patients with a moderate-severe course and 17 patients with a severe course), establishes clinical features of the course of the disease and laboratory markers associated with the severity of the course of the disease and myocardial fibrosis. The severity of the course of the disease was determined based on the volume of myocardial damage, the stage and functional class (FC) of heart failure, the presence of systolic heart dysfunction and life-threatening rhythm and conduction disorders. Statistical processing of the research results was carried out using the created database of examined patients in the StatSoft Statistica v 10.0 program, with a known number of observations (n). The Mann-Whitney test was used to determine differences between quantitative traits. Spearman's rank correlation coefficient was calculated to determine the degree of statistical dependence between indicators. It was established that myocarditis mostly had a course of moderate severity (64,6 %) with the presence of heart failure of II A stage in 54,8 % of inspected patients, and was accompanied by combined complex rhythm and conduction disorders in 38,7 % of patients. A reliable correlation was established between the increase in markers of inflammation (CRP, fibrinogen), cardiomyocyte lysis (CFC-MV) and fibroblast growth factor 23 (FGF-23), which indicates an increase in profibrotic processes as a result of myocardium inflammatory damage. It is important to carry out a detailed study of the clinical features of myocarditis with the further perspective of developing diagnostic methods for timely etiopathogenetic treatment and forecasting the adverse course of the disease.

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Section: матеріали та методиunclassified

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Clinical, laboratory changes and fibroblast growth factor in patients with myocarditis

Myndziv¹,

Yarema²

2022

Rep. of Vinnytsia Nation. Med. Univ.

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“…Myocarditis, as defined by the World Health Organization, is an inflammation of the myocardium [1][2][3]. In contrast, inflammatory cardiomyopathy (DCMi) is an inflammatory myocardial disease that is associated with systolic and/or diastolic dysfunction as well as cardiac remodeling [4].…”

Section: Introductionmentioning

confidence: 99%

Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches

Baumeier

Harms

Aleshcheva

et al. 2023

JCM

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The diagnosis and specific and causal treatment of myocarditis and inflammatory cardiomyopathy remain a major clinical challenge. Despite the rapid development of new imaging techniques, endomyocardial biopsies remain the gold standard for accurate diagnosis of inflammatory myocardial disease. With the introduction and continued development of immunohistochemical inflammation diagnostics in combination with viral nucleic acid testing, myocarditis diagnostics have improved significantly since their introduction. Together with new technologies such as miRNA and gene expression profiling, quantification of specific immune cell markers, and determination of viral activity, diagnostic accuracy and patient prognosis will continue to improve in the future. In this review, we summarize the current knowledge on the pathogenesis and diagnosis of myocarditis and inflammatory cardiomyopathies and highlight future perspectives for more in-depth and specialized biopsy diagnostics and precision, personalized medicine approaches.

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Systolic left ventricular dysfunction in patients with clinically suspected myocarditis

Митьковская

Балыш

Статкевич

et al. 2020

Vescì Nac. akad. navuk Belarusì, Ser. med. navuk

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The aim of the study was to investigate the features of clinically suspected myocarditis complicated by the left ventricular systolic dysfunction development. 93 patients with clinically suspected myocarditis were examined. The average age was 36.63 ± 1.15 years. In 43.01 % of patients the disease was accompanied by a decrease in left ventricular systolic function. In the group of patients with left ventricular systolic dysfunction in comparison with those with preserved left ventricular ejection fraction, a significantly lower proportion of men (75 % versus 81 %, respectively, χ2 = 9.3, p < 0,01) and a higher average group age (40.7 ± 1.87 versus 33.6 ± 1.3 years, respectively, p < 0,01) were revealed. The course of the disease in patients with left ventricular systolic dysfunction was characterized by a more frequent development of rhythm disturbances (65 % versus 43.3 %, respectively, χ2 = 4.3, p < 0,05) and a higher heart rate at admission (94.5 (75‒100) and 85 (70‒89) beats per minute, respectively, p = 0.006). The structural and functional state of the heart according to echocardiography in patients with a reduced left ventricular ejection fraction versus comparison group was characterized by larger heart chambers sizes, more pronounced violations of local left ventricular contractility, more frequent involvement of the right ventricle in the pathological process (56.3 % versus 22.2 %, respectively, χ2 = 6.4, p < 0,05). The relationships between the left ventricular ejection fraction Весці Нацыянальнай акадэміі навук Беларусі. Серыя медыцынскіх навук. 2020. Т. 17, № 4. C. 452–460 453 and the patient’s age (r = ‒0.36), the value of the heart rate at admission (r = ‒0.32), the severity of heart failure at admission, the degree of impaired local contractility of the left ventricle, the degree of right ventricular function (TAPSE, r = 0.58), the severity of myocardial fibrosis according to cardiovascular magnetic resonance imaging (r = ‒0.32) were revealed.

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Cardiomyopathies - The special entity of myocarditis and inflammatory cardiomyopathy

Cited by 4 publications

References 85 publications

Clinical, laboratory changes and fibroblast growth factor in patients with myocarditis

Clinical, laboratory changes and fibroblast growth factor in patients with myocarditis

Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches

Systolic left ventricular dysfunction in patients with clinically suspected myocarditis

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