Das Herz bei viralen, bakteriellen und parasitären Infektionen

Abstract

The heart can be the primary target for a viral, bacterial or parasitic infection (primary myocarditis/inflammatory cardiomyopathy). It can also participate in the "collateral damage" due to toxins, chemo- and cytokines, autoreactive antibodies or the native and acquired immune response through T- and B-cells, monocytes and macrophages (secondary myocarditis/inflammatory cardiomyopathy), when it is not the dominant organ of the disease. Infective agents show remarkable organ specificity: viral infections, toxic and autoreactive processes affect primarily the myocardium and the pericardium, whereas bacterial infections prefer endothelial surfaces and cause endocarditis and, less frequently, pericarditis. They are even discussed as part of the inflammatory process involved in coronary artery disease. Infective agents and their adequate diagnosis and treatment are discussed for these clinical entities according to current guidelines and clinical pathways.

Septic cardiomyopathy: evidence for a reduced force-generating capacity of human atrial myocardium in acute infective endocarditis

“…SCMP may be induced by IE as demonstrated by animal studies showing that the vegetation-associated host (bacteria) protease activity not only leads to proteolytic tissue damage, as evidenced by the release of extracellular matrix fragments such as fibrinogen, but also induces inflammation and myocardial cell damage [7]. In this respect, it is essential to note that SCMP can be caused not only by IE but also by any infective focus in the organism that gives rise to systemic endotoxemia [8].…”