Immunosuppressive treatment of inflammatory cardiomyopathy patients
Inflammatory cardiomyopathy, defined as myocarditis associated with cardiac dysfunction is a main cause of heart failure. The acknowledgment of the underlying histological and molecular substrate may significantly contribute to improve the treatment of the disease that can be so devastating to require cardiac transplantation. Immunosuppression has been recognized as an effective therapeutic option for eosinophilic, giant cell, granulomatous myocarditis and for lymphocytic myocarditis associated with connective tissue disorders and with rejection of the transplanted heart. Treatment of idiopathic lymphocytic myocarditis particularly in its chronic form is still debated. Recent studies suggest that a negative PCR analysis of endomyocardial tissue for viral genomes and the detection of autoimmune markers, as HLA up-regulation and anti-heart autoantibodies, identify responders to immunosuppression improving the patients’ outcome even in an advanced stage of the disease. Recovery of cardiac function in responders to immunosuppression is associated with inhibition of cell death and with newly synthesized contractile material.
KeywordsImmunosuppressive Treatment Endomyocardial Biopsy Cardiac Sarcoidosis Acute Myocarditis Giant Cell Myocarditis
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