nach oben

Die Kardiologie

Erschienen in:

08.09.2016 | Herzinsuffizienz | CME

Myokarditis-Update

verfasst von: PD Dr. I. Kindermann, C. Ukena, F. Mahfoud, M. Böhm, A. Yilmaz, K. Klingel

Erschienen in: Die Kardiologie | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Myokarditis ist eine entzündliche Herzerkrankung mit vielen Ursachen. In Europa wird sie hauptsächlich durch Virusinfektionen hervorgerufen. Erschwert wird die Diagnostik der Myokarditis durch ein breites Spektrum an klinischen Symptomen. Neue diagnostische Kriterien ermöglichen es, in Zusammenschau klinischer Symptome mit nichtinvasiven Untersuchungsbefunden die Verdachtsdiagnose Myokarditis zu erhärten. Zur Diagnosesicherung gilt die Endomyokardbiopsie als Goldstandard. Trotz zunehmender Erkenntnisse über die Ätiologie und Pathophysiologie der Myokarditis sowie Fortschritte in der Diagnostik der Erkrankung fehlt es besonders bei der Virusmyokarditis an einer evidenzbasierten spezifischen Therapieempfehlung. Eine immunsuppressive Therapie ist u. a. bei Patienten mit Sarkoidose, einer eosinophilen Myokarditis sowie Riesenzellmyokarditis indiziert und kann auch bei Patienten mit chronischer, virusnegativer Myokarditis diskutiert werden. Diese Behandlungsmöglichkeit als auch andere immunmodulatorische und antivirale Therapiestrategien müssen in weiteren randomisierten, placebokontrollierten Studien untersucht werden.

Strauer BE, Kandolf R, Mall G et al (1994) Konsensusbericht: Myokarditis-Kardiomyopathie. Med Klin 89(Suppl 1):23–28

Caforio AL, Pankuweit S, Arbustini E et al (2013) Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on myocardial and pericardial diseases. Eur Heart J 34:2636–2648CrossRefPubMed

Fung G, Luo H, Qiu Y et al (2016) Myocarditis. Circ Res 118:496–514CrossRefPubMed

Kindermann I, Barth C, Mahfoud F et al (2012) Update on myocarditis. J Am Coll Cardiol 59:779–792CrossRefPubMed

Mueller KA, Mueller II, Eppler D et al (2015) Clinical and histopathological features of patients with systemic sclerosis undergoing endomyocardial biopsy. PLoS ONE 10:e0126707CrossRefPubMedPubMedCentral

Cooper LT, Berry GJ, Shabetai R (1997) Idiopathic giant-cell myocarditis – natural history and treatment. Multicenter Giant Cell Myocarditis Study Group Investigators. N Engl J Med 236:1860–1866CrossRef

Ronaldson KJ, Fitzgerald PB, McNeil JJ (2015) Clozapine-induced myocarditis, a widely overlooked adverse reaction. Acta Psychiatr Scand 132:231–240CrossRefPubMed

Schlitt A, Jordan K, Vordermark D et al (2014) Kardiotoxizität onkologischer Therapien. Dtsch Arztebl Int 111:161–168PubMedPubMedCentral

GBD 2013 Risk Factors Collaborators, Forouzanfar MH, Alexander L, Anderson HR (2015) Global, regional, and national incidence, prevalence and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet 386:743–800CrossRef

10.

Maron BJ, Levine BD, Washington RL et al (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 2: preparticipation screening for cardiovascular disease in competitive athletes: a scientific statement from the American Heart Association and American College of Cardiology. Circulation 132:e267–e272CrossRefPubMed

11.

Kytö V, Sipilä J, Rautava P (2013) The effect of gender and age on occurrence of clinically suspected myocarditis in adulthood. Heart 99:1681–1684CrossRefPubMed

12.

Fairweather D, Cooper LT, Blauwet LA (2013) Sex and gender differences in myocarditis and dilated cardiomyopathy. Curr Probl Cardiol 38:7–46CrossRefPubMedPubMedCentral

13.

Klingel K, Hohenadl C, Canu A et al (1992) Ongoing enterovirus-induced myocarditis is associated with persistent heart muscle infection: quantitative analysis of virus replication, tissue damage, and inflammation. Proc Natl Acad Sci USA 89:314–318CrossRefPubMedPubMedCentral

14.

Klingel K, Fabritius C, Sauter M et al (2014) The activating receptor NKG2D of natural killer cells promotes resistance against enterovirus-mediated inflammatory cardiomyopathy. J Pathol 234:164–177PubMed

15.

Boivin-Jahns V, Schlipp A, Hartmann S et al (2012) Antibodies to cardiac receptors. Herz 37:843–848CrossRefPubMed

16.

Ukena C, Kindermann M, Mahfoud F et al (2014) Diagnostic and prognostic validity of different biomarkers in patients with suspected myocarditis. Clin Res Cardiol 102:743–751CrossRef

17.

Mahfoud F, Gärtner B, Kindermann M et al (2011) Virusserology in patients with supected myocarditis: utility of futility? Eur Heart J 32:897–903CrossRefPubMed

18.

Kühl U, Pauschinger M, Bock T et al (2003) Parvovirus B19 infection mimicking acute myocardial infarction. Circulation 108:945–950CrossRefPubMed

19.

Ukena C, Mahfoud F, Kindermann I et al (2011) Prognostic electrocardiographic parameters in patients with suspected myocarditis. Eur J Heart Fail 13(4):398–405. doi:10.1093/eurjhf/hfq229 CrossRefPubMed

20.

Mahfoud F, Ukena C, Kandolf R et al (2012) Blood pressure and heart rate predict outcome in patients acutely admitted for suspected myocarditis without previous heart failure. J Hypertens 30:1217–1224CrossRefPubMed

21.

Yilmaz A, Klingel K, Kandolf R et al (2009) Imaging in inflammatory heart disease: from the past to current clinical practice. Hellenic J Cardiol 50:449–460PubMed

22.

Uhrhausen A, Kindermann M, Böhm M et al (2003) Images in cardiovascular medicine. Diagnosis of myocarditis by cardiac tissue velocitiy imaging in an Olympic athlete. Circulation 108:e21–e22CrossRef

23.

Hsiao JH, Koshino Y, Bonnichsen CR et al (2013) Spreckle tracking echocardiography in acute myocarditis. Int J Cardiovasc Imaging 29:275–284CrossRefPubMed

24.

Baccouche H, Mahrholdt H, Meinhardt G et al (2009) Diagnostic synergy of non-invasive cardiovascular magnetic resonance and invasive endomyocardial biopsy in troponin-positive patients without coronary artery disease. Eur Heart J 30:2869–2879CrossRefPubMed

25.

Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37(27):2129–2200. doi:10.1093/eurheartj/ehw128 CrossRefPubMed

26.

Abdel-Aty H, Boye P, Zagrosek A et al (2005) Diagnostic performance of cardiovascular magnetic resonance in patients with suspected acute myocarditis: comparison of different approaches. J Am Coll Cardiol 45:1815–1822CrossRefPubMed

27.

Friedrich MG, Strohm O, Schulz-Menger J et al (1998) Contrast media-enhanced magnetic resonance imaging visualizes myocardial changes in the course of viral myocarditis. Circulation 97:1802–1809CrossRefPubMed

28.

Gutberlet M, Spors B, Thoma T et al (2008) Suspected chronic myocarditis at cardiac MR: diagnostic accuracy and association with immunohistologically detected inflammation and viral persistence. Radiology 246:401–409CrossRefPubMed

29.

Friedrich MG, Sechtem U, Schulz-Menger J et al (2009) Cardiovascular magnetic resonance in myocarditis: A JACC White Paper. J Am Coll Cardiol 53:1475–1487CrossRefPubMedPubMedCentral

30.

Florian A, Schaufele T, Ludwig A et al (2015) Diagnostic value of CMR in young patients with clinically suspected acute myocarditis is determined by cardiac enzymes. Clin Res Cardiol 104:154–163CrossRefPubMed

31.

Lurz P, Eitel I, Adam J et al (2012) Diagnostic performance of CMR imaging compared with EMB in patients with suspected myocarditis. JACC Cardiovasc Imaging 5:513–524CrossRefPubMed

32.

Chu GC, Flewitt JA, Mikami Y et al (2013) Assessment of acute myocarditis by cardiovascular MR: diagnostic performance of shortened protocols. Int J Cardiovasc Imaging 29:1077–1083CrossRefPubMed

33.

Ferreira VM, Piechnik SK, Dall’Armellina E et al (2013) T(1) mapping for the diagnosis of acute myocarditis using CMR: comparison to T2-weighted and late gadolinium enhanced imaging. JACC Cardiovasc Imaging 6(10):1048–1058. doi:10.1016/j.jcmg.2013.03.008 CrossRefPubMed

34.

Hinojar R, Foote L, Arroyo UE et al (2015) Native T1 in discrimination of acute and convalescent stages in patients with clinical diagnosis of myocarditis: a proposed diagnostic algorithm using CMR. JACC Cardiovasc Imaging 8:37–46CrossRefPubMed

35.

Cooper LT, Baughman KL, Feldmann AM et al (2007) The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology and the Eruopean Societey of Cardiology. Circulation 116:2216–2233CrossRefPubMed

36.

Yilmaz A, Kindermann I, Kindermann M et al (2010) Comparative evaluation of left and right ventricular endomycardial biopsy. Differences in complication rate and diagnostic performance. Circulation 122:900–909CrossRefPubMed

37.

Schäufele TG, Spittler R, Karagianni A et al (2015) Transradial left ventricular endomyocardial biopsy: assessment of safety and efficacy. Clin Res Cardiol 104:773–781CrossRefPubMed

38.

Klingel K, Sauter M, Bock CT et al (2004) Molecular pathology of inflammatory cardiomyopathy. Med Microbiol Immunol 193:101–107CrossRefPubMed

39.

Bock CT, Klingel K, Kandolf R (2010) Human parvovirus B19-associated myocarditis. N Engl J Med 362:1248–1249CrossRefPubMed

40.

Priori SG, Blomström-Lundqvist C, Mazzanti A et al (2015) 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J 36:2793–2867CrossRefPubMed

41.

Godsel LM, Leon JS, Wang K et al (2003) Captopril prevents experimental autoimmune myocarditis. J Immunol 171:346–352CrossRefPubMed

42.

Yuan Z, Shioji K, Kihara Y et al (2004) Cardioprotective effects of carvedilol on acute autoimmune myocarditis: antiinflammatory effects associated with antioxidant property. Am J Physiol Heart Circ Physiol 286:H83–H90CrossRefPubMed

43.

Rezkalla S, Kloner RA, Khatib G et al (1988) Effect of metoprolol in acute coxsackievirus B3 murine myocarditis. J Am Coll Cardiol 12:412–414CrossRefPubMed

44.

Kindermann I, Kindermann M, Kandolf R et al (2008) Predictors of outcome in patients with suspected myocarditis. Circulation 118:639–648CrossRefPubMed

45.

Lenarczyk R, Potpara TS, Haugaa KH et al (2016) The use of wearable cardioverter-defibirllators in Europe: results of the European Heart Rhythm Association survey. Europace 18:146–150CrossRefPubMed

46.

Maroon BJ, Udelson JE, Bonow RO et al (2015) Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis. Circulation 132:E 273–E 280CrossRef

47.

Cabininan AE, Kiel RJ, Smith F et al (1990) Modification of exercise-aggraved coxsackievirus B3 murine myocarditis by T lymphocyte suppression in an inbred model. J Lab Clin Med 115(4):454–462

48.

Mason JW, O’Connell JB, Herskowitz A et al (1995) A clinical trial of immunosuppressive therapy for myocarditis. The Myocarditis Treatment Trial Investigators. N Engl J Med 333:269–275CrossRefPubMed

49.

Frustaci A, Russo MA, Chimenti C (2009) Randomized study of the efficacy of immunosuppressive therapy in patients with virus-negative cardiomyopathy: the TIMIC study. Eur Heart J 30:1995–2002CrossRefPubMed

50.

Wojnicz R, Nowalany-Kozielzka E, Wojciechowska C et al (2001) Randomised, placebo controlled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy: two-year follow up-results. Circulation 104:39–45CrossRefPubMed

51.

Mobini R, Staudt A, Felix SB et al (2003) Haemodynamic improvement and removal of autoantibodies against beta1-adrenergic receptor by immunoadorption therapy in dilated cardiomyopathy. J Autoimmun 20:345–350CrossRefPubMed

52.

Felix SB, Staudt A, Landsberger M et al (2002) Removal of cardiodepressant antibodies in dilated cardiomyopathy by immunadsorption. J Am Coll Cardiol 39:646–652CrossRefPubMed

53.

Orange JS, Hossny EM, Weiler CR et al (2006) Primary Immunodeficiency Committee of the American Academy of of Allergy, Asthma and Immunology. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol 117(4 suppl):S525–S553CrossRefPubMed

54.

Gullestad L, Aass H, Fjeld JG et al (2001) Immunomodulating therapy with intravenous immunoglobulin in patient with chronic heart failure. Circulation 103:2254–2259CrossRef

55.

Mc Namara DM, Holubkov R, Starling RC et al (2001) Controlled trial of intravenous immune globulin in recent-onset dilated cardiomyopathy. Circulation 103:220–225CrossRef

56.

Kühl U, Pauschinger M, Schwimmbeck PL et al (2003) Interferon-beta treatment eliminates cardiotropic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular function in patiens with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation 117:S525–S553

57.

Kühl U, Lassner D, von Schlippenbach J et al (2012) Interferon-beta improves survival in Enterovirus-associated cardiomyopathy. J Am Coll Cardiol 60:1295–1296CrossRefPubMed

58.

Krueger GR, Ablashi DV (2003) Human Herpesvirus-6: a short review of its biological behavior. Intervirology 46:257–269CrossRefPubMed

59.

Jensen LD, Märchhand DJ (2016) Emerging pharmacologic targets and treatments for myocarditis. Pharmacol Ther 161:40–51CrossRefPubMed

60.

Caforio AL, Calabrese S, Angelini A et al (2007) A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Euro Heart J 28:1326–1333CrossRef

61.

McCarthy RE 3rd, Boehmer JP, Hruban RH et al (2000) Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis. N Engl J Med 342:690–695CrossRefPubMed

62.

Grün S, Schumm J, Greulich S et al (2012) Long-term follow-up for biopsy-proven viral myocarditis. J Am Coll Cardiol 59:1604–1615CrossRefPubMed

Titel: Myokarditis-Update
verfasst von: PD Dr. I. Kindermann
C. Ukena
F. Mahfoud
M. Böhm
A. Yilmaz
K. Klingel
Publikationsdatum: 08.09.2016
Verlag: Springer Berlin Heidelberg
Schlagwörter: Herzinsuffizienz
Kardiomyopathie
Myokarditis
Sarkoidose
Sarkoidose
Erschienen in: Die Kardiologie / Ausgabe 5/2016
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI: https://doi.org/10.1007/s12181-016-0084-2

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Myokarditis-Update

Zusammenfassung

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2016

Spiel, Satz und Sieg: TAVI?

Transkatheter-Klappenimplantation: TAVI bei Patienten mit niedrigem Risiko

„Never give up!“

Besseres Überleben durch Amiodaron oder Lidocain?

Kriterien der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. für „Brustschmerz-Ambulanzen“

41-jähriger Patient mit akutem Koronarsyndrom ungewöhnlicher Ursache