Republished: Pathogenesis and diagnosis of myocarditis

Abstract

Acute myocarditis is an inflammatory disease of the heart muscle that may progress to dilated cardiomyopathy and chronic heart failure. A number of factors including the sex hormone testosterone, components of innate immunity, and profibrotic cytokines have been identified in animal models as important pathogenic mechanisms that increase inflammation and susceptibility to chronic dilated cardiomyopathy. The clinical presentation of acute myocarditis is non-specific and mimics more common causes of heart failure and arrhythmias. Suspected myocarditis is currently confirmed using advanced non-invasive imaging and histopathologic examination of heart tissue. However, the diverse presentations of myocarditis and the lack of widely available, safe, and accurate non-invasive diagnostic tests remain major obstacles to early diagnosis and population based research. Recent advances in the understanding of disease pathogenesis described in this review should lead to more accurate diagnostic algorithms and non-invasive tests.

The Frequency of Invariant Natural Killer T Cells Correlates with the Severity of Myocarditis

“…However, lack of effective diagnostic and treatment measures make it one of the most important causes of sudden cardiac death and chronic heart failure (2). Among the causes of myocarditis, Coxsackievirus B3 (CVB3) has been considered to be one of the most common pathogenic factors (2,3), of which the pathogenesis is still in discussion.…”

Miocardiopatía dilatada por miocarditis aguda: ¿Bordetella pertussis como agente causal?

“…1 Si bien el diagnóstico de confirmación se establece con base en el reporte histológico deben integrarse los criterios clínicos, analíticos, electrocardiográficos y de imagen. 2 Se han descrito múltiples causas de miocarditis en pacientes pediátricos; no obstante, la infección representa el principal motivo de incidencia en estos casos. 3…”

Non-Rheumatic Myocarditides

“…При вирусном поражении чаще всего преобладают лимфоциты, а при бактери-альном -полиморфноядерные клетки, эозинофильная инфильтрация характерна для аллергических миокар-дитов. У пациентов с хронической СН и дилатацион-ной кардиомиопатией очаги воспалительных клеточ-ных инфильтратов обнаруживают примерно в 30 % случаев, у пациентов с системными заболеваниями -в 10-20 %, при этом инфильтрация носит диффузный характер [9,10]. Л е к ц и я миокардит легкой, средней и тяжелой степени.…”