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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
Summary
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.
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