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Immunohistological diagnosis of inflammatory cardiomyopathy and diagnosis of cardiotropic viral infections

  • Chapter
Inflammatory Cardiomyopathy (DCMi)

Part of the book series: Progress in Inflammation Research ((PIR))

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Abstract

Inflammatory cardiomyopathy (DCMi) is a specific cardiomyopathy entity of dilated cardiomyopathy (DCM), being defined by the proof of intramyocardial inflammation and/or viral infection in endomyocardial biopsies (EMBs). The immunohistological evaluation of EMBs, comprising the quantification of infiltrates and of cell adhesion molecule expression, has proven substantially more sensitive and specific compared with the histological EMB investigations according to the Dallas criteria. The molecular biological diagnosis of viral genomes comprises PCR for the qualitative evaluation, quantitative PCR for the determination of viral loads, and sequencing for the analysis of viral genotypes. By these techniques, DCMi has been detected in ca. 60% of the patients clinically presenting with either acute myocarditis (AMC) or DCM. DCMi assessed by immunohistology and viral persistence constitutes a prognostic factor for adverse outcome in AMC and DCM patients. Finally, this contemporary diagnostic repertoire is essential for the selection of DCMi patients who will likely benefit from immunosuppression or antiviral interferon treatment.

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Authors and Affiliations

  1. Department of Internal Medicine — Cardiology, University Hospital of Marburg and Giessen, Philipps-Universität Marburg, Baldinger Strasse 1, 35033, Marburg, Germany

    Michel Noutsias

  2. Department of Cardiology and Pneumonology, Charité — Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Heinz-Peter Schultheiss & Uwe Kühl

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  1. Michel Noutsias
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  2. Heinz-Peter Schultheiss
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  3. Uwe Kühl
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  1. Department of Cardiology and Pneumology, Charité—Universitätsmedizin Berlin Campus Benjamin Franklin, Hinderburgdamm 30, 12200, Berlin, Germany

    Heinz-Peter Schultheiss  & Michel Noutsias  & 

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Noutsias, M., Schultheiss, HP., Kühl, U. (2010). Immunohistological diagnosis of inflammatory cardiomyopathy and diagnosis of cardiotropic viral infections. In: Schultheiss, HP., Noutsias, M. (eds) Inflammatory Cardiomyopathy (DCMi). Progress in Inflammation Research. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8352-7_10

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  • DOI: https://doi.org/10.1007/978-3-7643-8352-7_10

  • Publisher Name: Birkhäuser Basel

  • Print ISBN: 978-3-7643-8351-0

  • Online ISBN: 978-3-7643-8352-7

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