[Myocarditis and dilated cardiomyopathy. New methods in diagnosis and therapy]

In 20% of cases, acute myocarditis can progress to dilated cardiomyopathy as a result of persistence of intramyocardial inflammation or of a virus genome. Both acute myocarditis (10-year survival rate 45%) and dilated cardiomyopathy (leading indication for cardiac transplantation) have a grave prognosis. Etiopathogenic differentiation of dilated cardiomyopathy was made possible for the first time by the use of immunohistochemical and molecular-biological diagnostic procedures applied to endomyocardial biopsy material. In addition to conventional treatment of heart failure, initial randomized studies have shown immunosuppression and antiviral immunomodulation to be effective measures and harbingers of a new era of rational therapeutic concepts in the treatment of dilated cardiomyopathy.