Myocarditis is an inflammation of the heart muscle. The most common cause of myocarditis is viral infection in industrialized countries. Myocarditis with left ventricular dysfunction is called inflammatory cardiomyopathy and is the major cause of dilated cardiomyopathy. Read More
Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, D-50937, Cologne, Germany.
Background: The aim of this study was to evaluate the diagnostic potential of a novel cardiovascular magnetic resonance (CMR) based multiparametric imaging approach in suspected myocarditis and to compare it to traditional Lake Louise criteria (LLC).
Methods: CMR data from 67 patients with suspected acute myocarditis were retrospectively analyzed. Seventeen age- and gender-matched healthy subjects served as control. Read More
Departement of Pediatrics, UTSW Medical Center, Dallas, TX, USA.
Over the last decade, human herpesvirus 6 (HHV-6) has been implicated in the etiology of pediatric myocarditis and subsequent dilated cardiomyopathy (DCM). This review provides an overview of recent literature investigating the pathophysiological relevance of HHV-6 in inflammatory cardiomyopathy. We examined 11 cases of previously published pediatric myocarditis and/or DCM associated with HHV-6 and also our experience of detection of virus particles in vascular endothelium of HHV-6 positive endomyocardial biopsy tissue by electron microscopy. Read More
Background Accurate diagnosis of cardiovascular involvement in systemic lupus erythematosus (SLE) remains challenging, due to limitations of echocardiography. We hypothesized that cardiovascular magnetic resonance can detect cardiac lesions missed by echocardiography in SLE patients with atypical symptoms. Aim To use cardiovascular magnetic resonance in SLE patients with atypical symptoms and investigate the possibility of silent heart disease, missed by echocardiography. Read More
This manuscript describes an outbreak of fatal toxoplasmosis in wallabies. Ten adult red necked wallabies (Macropus rufogriseus) were imported from New Zealand to the Virginia Zoo. Agglutination testing upon admission into quarantine showed all animals to be negative for antibodies to Toxoplasma gondii. Read More
Background: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. Read More
Suspect serious adverse event associated with vaccination in gimmersMultiple congenital defects in a stillborn calfSuspected alpha mannosidosis in a bovine fetusClostridial myocarditis in a two-week-old lambOtitis media in pigs These are among matters discussed in the disease surveillance report for May 2017 from SAC Consulting: Veterinary Services (SAC C VS). Read More
Background: Although sexual activity can cause moderate stress, it can cause natural death in individuals with pre-existing illness. The aim of this study was to identify additional pre-existing health problems, sexual practices, and potential circumstances that may trigger fatal events.
Methods: This medicolegal postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine of the University hospital, Goethe-University, Frankfurt/Main, Germany. Read More
aClinical and Experimental Department of Medicine, University of Messina, Messina bCardiac Department, Vannini Hospital Rome, Roma cRadiology Department, Humanitas Research Hospital, I.R.C.C.S., Milan dDivision of Cardiology, Villa dei Fiori, Napoli, Italy eMount Sinai School of Medicine, New York, New York, USA fSection of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa gU.O. Cardiologia e UTIC, ASST Monza, P.O. Desio, Desio hGabriele Monasterio Foundation-CNR Region Toscana, Pisa iCardiology Department, Policlinico Casilino, Rome jCardiac Department, Centro cardiologico Monzino, Milano kDivision of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, Padua lRadiological Department, European Hospital, Roma mDepartment of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
Aims: Poor data exist about cardiac magnetic resonance (CMR) findings in a large sample of acute myocarditis with different clinical presentations (heart failure, arrhythmias, and infarct-like presentation).
Methods: Five hundred and forty-three in-patients with a clinical suspected of acute myocarditis confirmed by CMR were enrolled. The clinical indications to perform CMR were chest pain and/or dyspnea and/or palpitations, or effort intolerance/malaise in the last month; elevated troponin and/or new ventricular dysfunction, and/or new ECG abnormalities; and suspected inflammatory cause. Read More
Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a pulmonary-renal syndrome affecting small and medium sized blood vessels. The disease has a prevalence in studies ranging from 3 to 15.7 cases per 100,000, with a noted increasing incidence and prevalence in more recent studies. Read More
Obesity is a growing problem in modern society and medicine. It closely associates with metabolic disorders such as type 2 diabetes mellitus (T2DM) and hepatic and cardiovascular diseases such as nonalcoholic fatty liver disease, atherosclerosis, myocarditis, and hypertension. Obesity is often associated with latent inflammation; however, the link between inflammation, obesity, T2DM, and cardiovascular diseases is still poorly understood. Read More
From the Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Germany (C.T., Y.X., K.S., F.S., B.P., U.K., S.V.L.); DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany (C.T., I.M., K.P., B.P., S.V.L.); Berlin-Brandenburg Center for Regenerative Therapies, Charité, University Medicine Berlin, Campus Virchow, Germany (C.T., I.M., K.P., K.M., S.V.L.); Department of Applied Biochemistry, Institute of Biotechnology, Technische Universität Berlin, Germany (S.P., H.F.); Institut Kardiale Diagnostik und Therapie (IKDT), Berlin, Germany (D.L., H.-P.S.); Institut für Mikrobiologie und Infektionsmedizin, Campus Benjamin Franklin, Berlin, Germany (M.M.H., S.B.); and Department of Cardiology, Deutsches Herzzentrum Berlin (DHZB), Germany (B.P.).
Background: The cytoplasmatic pattern recognition receptor, NOD2 (nucleotide-binding oligomerization domain 2), belongs to the innate immune system and is among others responsible for the recognition of single-stranded RNA. With Coxsackievirus B3 (CVB3) being a single-stranded RNA virus, and the recent evidence that the NOD2 target, NLRP3 (NOD-like receptor family, pyrin domain containing 3) is of importance in the pathogenesis of CVB3-induced myocarditis, we aimed to unravel the role of NOD2 in CVB3-induced myocarditis.
Methods And Results: Endomyocardial biopsy NOD2 mRNA expression was higher in CVB3-positive patients compared with patients with myocarditis but without evidence of persistent CVB3 infection. Read More
From the Houston Methodist DeBakey Heart and Vascular Center (B.H.T.), TX; University of Miami Leonard Miller School of Medicine, FL (J.M.H.); and Interdisciplinary Stem Cell Institute, Miami, FL (J.M.H.).
Inflammatory activation occurs in nearly all forms of myocardial injury. In contrast, inflammatory cardiomyopathies refer to a diverse group of disorders in which inflammation of the heart (or myocarditis) is the proximate cause of myocardial dysfunction, causing injury that can range from a fully recoverable syndrome to one that leads to chronic remodeling and dilated cardiomyopathy. The most common cause of inflammatory cardiomyopathies in developed countries is lymphocytic myocarditis most commonly caused by a viral pathogenesis. Read More
From the Imperial College London, United Kingdom (W.J.M.); Hypertrophic Cardiomyopathy Institute, Division of Cardiology, Tufts Medical Center, Boston, MA (B.J.M.); and Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Italy (G.T.).
In the past 25 years, major advances were achieved in the nosography of cardiomyopathies, influencing the definition and taxonomy of this important chapter of cardiovascular disease. Nearly, 50% of patients dying suddenly in childhood or adolescence or undergoing cardiac transplantation are affected by cardiomyopathies. Novel cardiomyopathies have been discovered (arrhythmogenic, restrictive, and noncompacted) and added to update the World Health Organization classification. Read More
Myocarditis is a major cause of sudden, unexpected death in young people. However, it is still one of the most challenging diseases to treat in cardiology. In the present study, we showed that both expression level and activity of PKC-α were up-regulated in the rat heart of experimental autoimmune myocarditis (EAM). Read More
Background: As chronic Chagas disease does not have a definitive treatment, the development of alternative therapeutic protocols is a priority. Dipyridamole (DPY) is an alternative to counteract the pathophysiological phenomena involved in Chagas cardiomyopathy.
Objective: To evaluate the therapeutic efficacy of DPY associated with nifurtimox (Nfx) in epimastigote axenic cultures and in mice with acute Chagas disease. Read More
Background: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application.
Patients And Methods: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO. Read More
Objective: In the context of clinical evaluations performed on our prospective myositis cohort, we noted a striking association of severe cardiac disease in myositis patients with antimitochondrial antibodies. We sought to review all cases of antimitochondrial antibody (AMA) associated myositis in our cohort to describe the clinical features of this disease subset.
Methods: We identified 7 patients with confirmed antimitochondrial antibodies who presented as an inflammatory myopathy. Read More
PD-1 plays an important role in protecting against inflammation and myocyte damage in T cell mediated myocarditis. To understand whether FGL2 can affect the role of PD-1/PD-L1 pathway in experimental autoimmune myocarditis (EAM),we investigated the cardiac function in EAM rats overexpressing FGL2. Overexpression of FGL2 significantly decreased PD-1 and deteriorated cardiac function in autoimmune myocarditis rats. Read More
In this study, we investigated the roles of RIP1/RIP3 mediated cardiomyocyte necroptosis in CVB3-induced acute myocarditis. Serum concentrations of creatinine kinase (CK), CK-MB, and cardiac troponin I were detected using a Hitachi Automatic Biochemical Analyzer in a mouse model of acute VMC. Histological changes in cardiac tissue were observed by light microscope and expression levels of RIP1/RIP3 in the cardiac tissue were detected via Western blot and immunohistochemistry. Read More
1,25-dihydroxyvitamin D3 and its analog (paricalcitol) have beneficial effects on multiple systems and diseases, including myocarditis. However, the therapeutic effect of cholecalciterol cholesterol emulsion (CCE) on myocarditis and the role of pyroptosis in the progress of myocarditis have not been determined. The objective of this study was to investigate the effect of CCE on experimental autoimmune myocarditis and its underlying mechanisms. Read More
Coxsackievirus B3 (CVB3) is an important inducer of myocarditis, which, in susceptible individuals, can chronify and eventually lead to the development of dilated cardiomyopathy and heart failure. The respective mechanisms are not completely understood. Here, we analyzed expression of the TRAF6 gene, encoding TNF receptor-associated factor 6 (TRAF6), a signal transduction scaffold protein that acts downstream of cytokine receptors, in heart tissue of susceptible and non-susceptible mouse strains. Read More
Summary: We describe the case of a 24-year-old male with hyper-IgE syndrome (HIES) which was diagnosed at 4 years of age and died from a very rare cardiac complication. He had typical clinical and laboratory manifestations of HIES, including total serum IgE as high as > 100,000 IU/mL. Stem cell transplantation was not available. Read More
The patient was a 54-year-old woman, who died of chronic cardiac insufficiency after a clinical course of 2 years and 4 months. She had complained of myalgia, muscle weakness, and blepharoptosis before the onset of cardiac symptoms, but there was no evidence of myasthenia gravis or collagen-vascular diseases. At autopsy, the heart (280 g) showed marked dilatation of the four chambers and thinning of the ventricular walls. Read More
From Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Université Paris Diderot, Sorbonne Paris Cité, and Institut National de la Santé et de la Recherche Médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Université Paris Diderot, Sorbonne Paris Cité, and Institut National de la Santé et de la Recherche Médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris, Saint-Louis Hospital, Université Paris Diderot, Sorbonne Paris Cité, and Institut National de la Santé et de la Recherche Médicale, Paris, France.
Cardiol Res 2017 Aug 23;8(4):172-175. Epub 2017 Aug 23.
Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
Myocarditis is an inflammation of the myocardium. Clinical presentation ranges from non-specific systematic symptoms to fulminant collapse and sudden death. Sudden death occurs at rates of 8. Read More
Objectives: Bone marrow-derived cells (BMCs) have recently been identified to play a vital role in repairing damaged myocardium; however, it is not known whether or not mobilization of BMCs is involved in the pathogenesis of acute viral myocarditis (VMC). Thus, we analyzed the expression of CD45+CD34+VLA-4+ cells and vascular cell adhesion protein-1 (VCAM-1) in a murine model of acute VMC.
Methods: Male BALB/c mice were intraperitoneally infected with coxsackievirus B3 to establish acute VMC. Read More
Coxsackie B4 (CV-B4), is a major cause of viral myocarditis, dilated cardiomyopathy, and pancreatitis. Like other human enteroviruses, CV-B4 is ubiquitous, excreted in the stool, transmitted by fecal-oral route, and persists in the environment. In the context of studies on CV-B4 infection, it is important to investigate how this virus can be eliminated and to show the possibility of contamination risk with a CV-B4 E2 infected Swiss albino mice. Read More
As the concerns regarding Zika virus (ZIKV) are mostly of neurological disorders, especially in neonates and infants, other possible threats of the virus may have been overlooked. Our study focuses on the potential threat that ZIKV may pose to the heart like that of similar arboviral diseases. We conducted a literature search of multiple terms in March 2017 using the search engines, PubMed, Embase, and SCOPUS. Read More
Aims: Acute myocarditis is a potentially lethal inflammatory heart disease that frequently precedes the development of dilated cardiomyopathy and subsequent heart failure. At present, there is no effective standardized therapy for acute myocarditis, besides the optimal care of heart failure and arrhythmias in accordance with evidence-based guidelines and specific etiology-driven therapy for infectious myocarditis. Carvedilol has been shown to be cardioprotective by reducing cardiac pro-inflammatory cytokines present in oxidative stress in certain heart diseases. Read More
Coxsakievirus B3 (CVB3) is a member of enterovirus B (EVB) group, which can cause serious heart diseases such as viral myocarditis. In order to analyze the evolution of CVB3, we performed a recombination analysis of all viral genomes of enterovirus B, and found that there were 19 putative recombination events that produced CVB3. A total of 11 serotypes were found to be involved in the generation of CVB3 progeny virus. Read More
Influenza B is a rare cause of myocarditis that is usually caused by histiocytic and mononuclear cellular infiltrates. We describe a 22-year-old female patient presenting with fulminant myopericarditis secondary to influenza B infection that deteriorated to cardiogenic shock. Endomyocardial biopsy results yielded myocardial necrosis through complement-mediated cellular injury without evidence of interstitial infiltrates. Read More
Purpose Of Review: The purpose of this review is to provide an update on cardiovascular involvement in idiopathic inflammatory myopathy (IIM). Studies from the past 18 months are identified and reviewed. Finally, the clinical impact of these findings is discussed. Read More
The survival of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) who have access to highly active antiretroviral therapy (ART) has dramatically increased in recent times. This review focuses on HIV-associated heart failure in sub-Saharan Africa (SSA). In HIV infected persons, heart failure may be related to pathology of the pericardium, the myocardium, the valves, the conduction system, or the coronary and pulmonary vasculature. Read More
Therapeutic antibodies targeting the programmed cell death protein 1 (PD-1) pathway function as immune checkpoint inhibitors, allowing the immune system to recognize tumors which otherwise escape immune surveillance. However, these agents can also elicit an autoimmune response by inhibiting the ability of non-neoplastic tissues and regulatory cells to suppress the immune system. Here we present a fatal case of active myocarditis in a 55-year-old man with non-small-cell lung cancer which occurred following monotherapy with the PD-1 inhibitor nivolumab (Opdivo). Read More
aDivision of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital bThe Cape Universities Body Imaging Centre cThe Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Purpose Of Review: The purpose of this article is to review the literature on HIV and myocarditis and HIV-associated heart failure.
Recent Findings: Currently, 17 million people are receiving antiretroviral therapy (ART) globally. There is a decrease in mortality from HIV in the last decade with increased survival in those receiving ART. Read More
Aims: Retinoic acid receptor-related orphan nuclear receptor γt (RORγt) is a transcriptional factor responsible for IL-17-producing T-cell differentiation. Although it was demonstrated that RORγt plays essential roles in the onset of autoimmune myocarditis, pathophysiological significance of RORγt in cardiac remodeling after myocardial infarction (MI) remains to be fully elucidated.
Methods And Results: MI was generated by ligating coronary artery. Read More
During the course of Chagas disease, infectious forms of Trypanosoma cruzi are occasionally liberated from parasitized heart cells. Studies performed with tissue culture trypomastigotes (TCTs, Dm28c strain) demonstrated that these parasites evoke neutrophil/CXCR2-dependent microvascular leakage by activating innate sentinel cells via toll-like receptor 2 (TLR2). Upon plasma extravasation, proteolytically derived kinins and C5a stimulate immunoprotective Th1 responses via cross-talk between bradykinin B2 receptors (B2Rs) and C5aR. Read More
J Mol Cell Cardiol 2017 Oct 16;111:102-113. Epub 2017 Aug 16.
Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA. Electronic address:
Viral myocarditis is a leading cause of sudden death in young adults as the limited turnover of cardiac myocytes renders the heart particularly vulnerable to viral damage. Viruses induce an antiviral type I interferon (IFN-α/β) response in essentially all cell types, providing an immediate innate protection. Cardiac myocytes express high basal levels of IFN-β to help pre-arm them against viral infections, however the mechanism underlying this expression remains unclear. Read More
Exp Mol Pathol 2017 Aug 16;103(2):141-152. Epub 2017 Aug 16.
The Johns Hopkins University School of Medicine, Dept. of Pathology, Div. of Immunology, Baltimore, MD 21205, United States; The Johns Hopkins Bloomberg School of Public Health, The W. Harry Feinstone Dept. of Molecular Microbiology & Immunology, United States. Electronic address:
The extensive, diverse communities that constitute the microbiome are increasingly appreciated as important regulators of human health and disease through inflammatory, immune, and metabolic pathways. We sought to elucidate pathways by which microbiota contribute to inflammatory, autoimmune cardiac disease. We employed an animal model of experimental autoimmune myocarditis (EAM), which results in inflammatory and autoimmune pathophysiology and subsequent maladaptive cardiac remodeling and heart failure. Read More
Giant cell myocarditis is known as a rare and frequently fatal type of myocarditis that is usually characterized by progressive congestive heart failure and frequent ventricular arrhythmias. We report a rare case of giant cell myocarditis in a 64-year-old previously healthy woman. The case was complicated by the rapid development of progressive acute heart failure, which required the comprehensive care of our heart team. Read More