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Myocarditis and cardiomyopathy

Jonathan Buggey1, Chantal A ElAmm

  • 1University Hospitals Cleveland Medical Center, Harrington Heart and Vascular Institute, Cleveland, Ohio, USA.

Current Opinion in Cardiology
|March 13, 2018
PubMed

Insights

This review summarizes myocarditis, a cause of cardiomyopathy. Advancements in cardiac MRI aid diagnosis, but endomyocardial biopsy remains crucial for accurate assessment and treatment guidance.

Area of Science:

  • Cardiology
  • Immunology
  • Pathology

Background:

  • Myocarditis presents heterogeneously with potentially fatal outcomes.
  • Immune activation, including cytokine and autoantibody responses, drives myocardial damage.
  • Dilated cardiomyopathy develops in approximately one-third of myocarditis patients.

Purpose of the Study:

  • To review the pathogenesis, diagnosis, and management of myocarditis-associated cardiomyopathy.
  • To highlight recent advancements in understanding and diagnosing this condition.

Main Methods:

  • Literature review of studies on myocarditis and cardiomyopathy.
  • Analysis of diagnostic modalities, including cardiac MRI and endomyocardial biopsy.
  • Evaluation of current and emerging treatment strategies.

Main Results:

  • Cardiac MRI, particularly T1/T2 mapping, has improved diagnostic accuracy.
  • Endomyocardial biopsy, especially left ventricular sampling, is essential for definitive diagnosis.
  • Pathogenesis involves a complex, multi-phase immune response.

Conclusions:

  • Despite improved diagnostics, treatment for myocarditis-associated cardiomyopathy relies on standard heart failure therapies or advanced support.
  • Accurate diagnosis through biopsy aids prognostication and guides tailored treatment.
  • Further research is needed to develop targeted therapies for this unique pathophysiology.
Abstract

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