Acute viral myocarditis.

Acute viral myocarditis.
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DOI:
10.1093/eurheartj/ehn296
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发表时间:
2008-09
影响因子:
39.3
通讯作者:
Heymans S
Heymans S
中科院分区:
医学1区
文献类型:
--
作者:
Dennert R;Crijns HJ;Heymans S

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急性心肌炎是心脏病学最具挑战性的诊断之一。目前,由于传统诊断试验的不敏感性,没有普遍接受的诊断金标准。这导致需要新的诊断方法,这导致了新的分子测试和更详细的免疫组织化学分析的子宫内膜活检的出现。使用这些新的诊断测试的最新发现导致对炎性心肌病的兴趣增加,并对其病理生理学有了更好的理解,认识到病毒介导的损伤,炎症和自身免疫失调的重叠。新的研究结果还指出了导致急性心肌炎的更广泛的病毒基因组,表明肠道病毒和腺病毒转移到细小病毒B19和人类疱疹病毒6。本综述提出了一个一般的诊断方法,重点是病毒的病因学和相关的自身免疫过程,并审查急性病毒性心肌炎患者的治疗方案。
Acute myocarditis is one of the most challenging diagnosis in cardiology. At present, no diagnostic gold standard is generally accepted, due to the insensitivity of traditional diagnostic tests. This leads to the need for new diagnostic approaches, which resulted in the emergence of new molecular tests and a more detailed immunohistochemical analysis of endomyocardial biopsies. Recent findings using these new diagnostic tests resulted in increased interest in inflammatory cardiomyopathies and a better understanding of its pathophysiology, the recognition in overlap of virus-mediated damage, inflammation, and autoimmune dysregulation. Novel results also pointed towards a broader spectrum of viral genomes responsible for acute myocarditis, indicating a shift of enterovirus and adenovirus to parvovirus B19 and human herpes virus 6. The present review proposes a general diagnostic approach, focuses on the viral aetiology and associated autoimmune processes, and reviews treatment options for patients with acute viral myocarditis.
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