Author + information
- Received May 15, 2011
- Revision received August 22, 2011
- Accepted September 5, 2011
- Published online February 28, 2012.
- Ingrid Kindermann, MD⁎,⁎ (, )
- Christine Barth⁎,
- Felix Mahfoud, MD⁎,
- Christian Ukena, MD⁎,
- Matthias Lenski, MD⁎,
- Ali Yilmaz, MD†,
- Karin Klingel, MD‡,
- Reinhard Kandolf, MD‡,
- Udo Sechtem, MD†,
- Leslie T. Cooper, MD§ and
- Michael Böhm, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Ingrid Kindermann, Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse 1, Homburg/Saar 66421, Germany
Myocarditis is an inflammatory disease of the heart frequently resulting from viral infections and/or post-viral immune-mediated responses. It is one of the important causes of dilated cardiomyopathy worldwide. The diagnosis is presumed on clinical presentation and noninvasive diagnostic methods such as cardiovascular magnetic resonance imaging. Endomyocardial biopsy remains the gold standard for in vivo diagnosis of myocarditis. The therapeutic and prognostic benefits of endomyocardial biopsy results have recently been demonstrated in several clinical trials. Although remarkable advances in diagnosis, understanding of pathophysiological mechanisms, and treatment of acute myocarditis were gained during the last years, no standard treatment strategies could be defined as yet, apart from standard heart failure therapy and physical rest. In severe cases, mechanical support or heart transplantation may become necessary. There is some evidence that immunosuppressive and immunomodulating therapy are effective for chronic, virus-negative inflammatory cardiomyopathy. Further investigations by controlled, randomized studies are needed to definitively determine their role in the treatment of myocarditis.
This work was supported by the Deutsche Forschungsgemeinschaft (KFO 196 to Dr. Böhm and SFB-TR 19 to Drs. Kandolf and Klingel) and by the Ministry of Science and Economy of the State of the Saarland (Drs. Böhm and Kindermann). The authors have reported they have no relationships relevant to the contents of this paper to disclose.
- Received May 15, 2011.
- Revision received August 22, 2011.
- Accepted September 5, 2011.
- American College of Cardiology Foundation