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Myocarditis and cardiomyopathy.

D J Kereiakes, W W Parmley

    American Heart Journal
    |November 1, 1984
    PubMed
    Summary

    Lymphocytic myocarditis is increasingly diagnosed in patients with idiopathic dilated cardiomyopathy (ICCM). Viral infections may trigger immune responses leading to heart damage, but immunosuppressive therapy

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    Area of Science:

    • Cardiology
    • Immunology
    • Infectious Diseases

    Background:

    • Idiopathic dilated cardiomyopathy (ICCM) is often linked to lymphocytic myocarditis, increasingly detected via endomyocardial biopsy (EMB).
    • Myocarditis can manifest with diverse symptoms, including diastolic dysfunction, arrhythmias, and chest discomfort, even with normal coronary angiograms.
    • Viral infections are implicated as a primary cause of acute myocarditis and ICCM.

    Purpose of the Study:

    • To review the current understanding of myocarditis in ICCM.
    • To explore the potential role of immune mechanisms in myocardial damage.
    • To discuss the rationale for immunosuppressive therapy in myocarditis.

    Main Methods:

    • Review of existing epidemiologic and serologic data.
    • Analysis of clinical presentations and diagnostic findings in myocarditis patients.
    • Discussion of pathomechanisms involving viral triggers and immune responses.

    Main Results:

    • Widespread EMB application reveals a significant incidence of lymphocytic myocarditis in ICCM.
    • Most viral myocarditis cases resolve, but a subset progresses to chronic congestive cardiomyopathy.
    • Myocardial damage in chronic cases, without active viral infection, is thought to involve immune-mediated processes.

    Conclusions:

    • Virus-induced immune-mediated damage is a key concept for understanding myocarditis progression.
    • Immunosuppressive therapy is being explored as a treatment strategy for myocarditis.
    • Controlled clinical trials are needed to determine if immunosuppressive therapy impacts the natural history of myocarditis.

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