Treatment options in myocarditis and inflammatory cardiomyopathy : Focus on i. v. immunoglobulins.
Treatment options in myocarditis and inflammatory cardiomyopathy : Focus on i. v. immunoglobulins.
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DOI：
10.1007/s00059-018-4719-x
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发表时间：
2018-08
期刊：
影响因子：
1.7
通讯作者：
Alter P
中科院分区：
文献类型：
--
作者：
Maisch B;Alter P
对于心肌炎和炎性心肌病，病因驱动的治疗是当今心力衰竭治疗之外的最佳选择。这一点的先决条件是非侵入性和侵入性生物标志物，包括肌内膜活检和聚合酶链反应的心脏药物。多普勒超声心动图和心脏磁共振成像以及心脏生物标志物（如C反应蛋白、N末端B型利钠肽前体和肌钙蛋白）的成像有助于综合征的临床检查，但不能阐明潜在原因或发病过程。这篇综述总结了心肌炎的阶段和临床特征，并给出了一个最新的简短概述，目前的治疗方案开始与心力衰竭和抗心律失常治疗。虽然心肌疾病中的炎症可以自发消退，但通常需要针对病原体的特异性治疗。对于暴发性、急性和慢性自身反应性心肌炎，TIMIC和ESETCID试验已证明免疫抑制治疗有益;对于病毒性心肌病和心肌炎，静脉注射免疫球蛋白IgG亚型和多价静脉注射免疫球蛋白IgG、伊加和IgM通常可缓解炎症。然而，尽管消除了炎症，但根除细小病毒B19和人类疱疹病毒-6仍然是一个挑战，ivIg治疗可能成为未来的关键角色。
For myocarditis and inflammatory cardiomyopathy, an etiologically driven treatment is today the best option beyond heart failure therapy. Prerequisites for this are noninvasive and invasive biomarkers including endomyocardial biopsy and polymerase chain reaction on cardiotropic agents. Imaging by Doppler echocardiography and cardiac magnetic resonance imaging as well as cardiac biomarkers such as C‑reactive protein, N‑terminal pro-B-type natriuretic peptide , and troponins can contribute to the clinical work-up of the syndrome but not toward elucidating the underlying cause or pathogenetic process. This review summarizes the phases and clinical features of myocarditis and gives an up-to-date short overview of the current treatment options starting with heart failure and antiarrhythmic therapy. Although inflammation in myocardial disease can resolve spontaneously, often specific treatment directed against the causative agent is required. For fulminant, acute, and chronic autoreactive myocarditis, immunosuppressive treatment has proven to be beneficial in the TIMIC and ESETCID trials; for viral cardiomyopathy and myocarditis, intravenous immunoglobulin IgG subtype and polyvalent intravenous immunoglobulins IgG, IgA, and IgM can frequently resolve inflammation. However, despite the elimination of inflammation, the eradication of parvovirus B19 and human herpesvirus-6 is still a challenge, for which ivIg treatment can become a future key player.
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影响因子：
1.7
作者：
Maisch, B.;Alter, P.;Pankuweit, S.
通讯作者：
Pankuweit, S.
影响因子：
39.3
作者：
Frustaci, Andrea;Russo, Matteo A.;Chimenti, Cristina
通讯作者：
Chimenti, Cristina
影响因子：
158.5
作者：
Cooper, LT;Berry, GJ;Shabetai, R
通讯作者：
Shabetai, R
DOI：
10.1016/s0735-1097(85)80312-0
发表时间：
1985-01-01
影响因子：
24
作者：
COSTANZONORDIN, MR;REAP, EA;SCANLON, PJ
通讯作者：
SCANLON, PJ
影响因子：
1.6
作者：
Klugman, Darren;Berger, John T.;Slonim, Anthony D.
通讯作者：
Slonim, Anthony D.