Triggers of Inflammatory Heart Disease

Abstract

Inflammatory heart disease (IHD) is a group of diseases that includes pericarditis, myocarditis, and endocarditis. Although males appear to be more commonly affected than females, IHD can be seen in any age group. While the disease can be self-limiting leading to full recovery, affected individuals can develop chronic disease, suggesting that identification of primary triggers is critical for successful therapies. Adding to this complexity, however, is the fact that IHD can be triggered by a variety of infectious and non-infectious causes that can also occur as secondary events to primary insults. In this review, we discuss the immunological insights into the development of IHD as well as a mechanistic understanding of the disease process in animal models.

Anticipating the long-term cardiovascular effects of COVID-19

“…Myocarditis following a viral infection is viewed under the pathophysiology-based lens of autoinflammatory disease [16]. The inflammatory process can include the myocytes, interstitial elements or vasculature of the heart.…”

Mechanisms of sex hormones in autoimmunity: focus on EAE

“…However, healthy individuals can have signatures of autoimmune response as evidenced by the detection of low levels of antibodies and T cells against autoantigens that may reflect formation of natural antibodies or idiotypic networks [1][2][3][4]. Autoimmune diseases (AIDs) are clinically manifested when autoimmunity leads to tissue damage disrupting the functions of affected organs [5,6].…”

An overview of the immune mechanisms of viral myocarditis

“…18 Other viruses implicated in the causation of viral myocarditis include HCV (Flaviviridae family), HIV (Retroviridae family), EBV and CMV (Herpesviridae family), and influenza virus (Orthomyxoviridae family). 8,9,19 More recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belonging to the Coronaviridae family, causing the Coronavirus disease-19 (COVID- 19) has been implicated in the causation of viral myocarditis. [20][21][22][23] To study the pathogenesis of viral myocarditis, mouse models of CVB3 infection are commonly employed.…”

“…Various etiological agents – both infectious and non‐infectious – have been implicated in the causation of myocarditis (Figure 1A). 8,9 As to viruses, enteroviruses like Coxsackievirus B3 (CVB3) and adenovirus belonging to the Picornaviridae and Adenoviridae families, respectively, are commonly suspected in the U.S in all age groups in patients with chronic myocarditis/DCM 3,10 . Recent data, however, have revealed infections also caused by other viruses 11,12 .…”

“…Likewise, HHV‐6 belonging to the Herpesviridae family was detected in up to 43% of endomyocardial biopsies, leading to the suggestion that HHV‐6 be considered in pediatric patients with inflammatory cardiomyopathy or idiopathic DCM 18 . Other viruses implicated in the causation of viral myocarditis include HCV ( Flaviviridae family), HIV ( Retroviridae family), EBV and CMV ( Herpesviridae family), and influenza virus ( Orthomyxoviridae family) 8,9,19 . More recently, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) belonging to the Coronaviridae family, causing the Coronavirus disease‐19 (COVID‐19) has been implicated in the causation of viral myocarditis 20‐23 …”