Acute myocarditis. Role of histological and virological examination in the diagnosis and assessment of immunosuppressive treatment.

Daly, Kieran; Richardson, Peter J.; Olsen, E. G. J.; Morgan‐Capner, P.; McSorley, C.; Jackson, Graham; Jewitt, D E

doi:10.1136/hrt.51.1.30

Cited by 133 publications

(25 citation statements)

References 16 publications

(3 reference statements)

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“…Following the report by Mason and co-workers in 1980,n0 in which it was suggested that treatment with prednisone or prednisone plus azathioprine possibly reduced myocardial inflammation and improved the clinical outcome, investigators have published widely discrepant results ranging from no response with immunosuppressive therapyg4 to approximately 80% improvement .30. 76 Again, there is a variety of reasons why it is difficult to draw meaningful conclusions from the available literature. First, the natural history of myocarditis is poorly de- fined.…”

Section: Immunosuppression In Myocarditismentioning

confidence: 99%

Myocarditis: Unresolved issues in diagnosis and treatment

Maze

Adolph

1990

Clinical Cardiology

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Summary: Myocarditis is an enigmatic disease. Lymphocytic myocarditis is most commonly viral in origin. Considerable evidence suggests that myocardial damage is due to an immune-mediated mechanism rather than to direct effects of the virus itself. The presentation is variable, ranging from a clinically inapparent or relatively benign illness to acute progressive heart failure and death. Although examination of the endomyocardial biopsy specimen is the "gold standard" for the diagnosis of myocarditis there are problems with this technique, relating particularly to sampling error and histologic interpretation. Considerable evidence, both animal and human, suggests that a link between viral myocarditis and dilated cardiomyopathy does exist. There is a rational basis for the use of immunosuppressive therapy in myocarditis. Although many favorable responses have been reported with the use of these agents, the results of more definitive studies are awaited to determine the role of immunosuppressive therapy in myocarditis more clearly. Recommendations for the practical management of patients with myocarditis are made. Whenever possible, patients with this diagnosis should be entered into the ongoing NIH trial.

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Section: Immunosuppression In Myocarditismentioning

confidence: 99%

Myocarditis: Unresolved issues in diagnosis and treatment

Maze

Adolph

1990

Clinical Cardiology

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“…In an extensive virologic study of patients with clinical and histological evidence of myocarditis, a positive serologic test result was found in only 50% of cases. 6 The present diagnosis of acute myocarditis was not definite because the patient did not undergo endomyocardial biopsy, cardiovascular magnetic resonance imaging, or voltage mapping of the ventricle. 7, 8 Despite this, the likelihood of acute myocarditis was high based on the other clinical data.…”

Section: Images In Cardiovascular Medicine Ito S Et Almentioning

confidence: 85%

Persistent Electrical Scar in the Atrium Evaluated on Voltage Mapping With a CARTO System in Suspected Acute Myocarditis

Ito¹,

Kamegai²,

Murakami³

et al. 2012

Circ J

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“…involve an autoimmune mechanism, and that immunosuppressive therapy may be effective in such cases. Immunosuppressive therapy has proved effective in a few eases of myocarditis [7,8]. Gilbert et al reported thai therapy with OKT3 MoAb was probably beneficial in one patient with myocarditis [27].…”

Section: Discussionmentioning

confidence: 99%

Anti-αβ T cell receptor antibody prevents the progression of experimental autoimmune myocarditis

Hanawa

Kodama

Inomata

et al. 1994

Clinical and Experimental Immunology

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SUMMARYWe investigated the effects of anii-ali T cell receptor antibody in rat experimental autoimmune myocarditis (HAM), using a new anitnal model of autoimtnune myocarditis characterized by the appearance of multinucleated giant cells. KAM was induced by injecting Lewis rats subcutancously in the footpads with I Omg of human cardiac myosin in an equal volume of Freund's complete adjuvant (FCA) on days 0 and 7. In experiment 1, we evaluated the effect of long-term anti-a/:/TCR antibody therapy on prevention of progression of EAM. Long-term adtninistration of anli-n(? TCR antibody prevented progression of FAM in a dose-dependent tnanner. Flow cytometry performed at the time of sacrifice showed that the percentage of tyii T cells in lymph nodes and spleen was similar in the control group and the group in which almost no histologic evidence of myocarditis was found. In experiment 2, we examined the eflfecls of short-term therapy. Rats were killed at difTerent stages and pathologic specimens were examined. Short-term therapy delayed the onset of myocarditis. Results of flow cytomelry suggested that impairment of antigen recognition or T cell function by occupancy of the TCR rather than depletion of TCR was the mechanism responsible for suppression of EAM.

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Acute myocarditis. Role of histological and virological examination in the diagnosis and assessment of immunosuppressive treatment.

Cited by 133 publications

References 16 publications

Myocarditis: Unresolved issues in diagnosis and treatment

Myocarditis: Unresolved issues in diagnosis and treatment

Persistent Electrical Scar in the Atrium Evaluated on Voltage Mapping With a CARTO System in Suspected Acute Myocarditis

Anti-αβ T cell receptor antibody prevents the progression of experimental autoimmune myocarditis

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