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Cited by 359Viral Infections and Immunology ResearchCardiomyopathy and Myosin StudiesCardiovascular Effects of Exercise

The Quest for New Approaches in Myocarditis and Inflammatory Cardiomyopathy

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Heymans, Stephane, Eriksson, Urs, Lehtonen, Jukka, Cooper, Leslie T.·2016·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2016.09.937
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Abstract

Myocarditis is a diverse group of heart-specific immune processes classified by clinical and histopathological manifestations. Up to 40% of dilated cardiomyopathy is associated with inflammation or viral infection. Recent experimental studies revealed complex regulatory roles for several microribonucleic acids and T-cell and macrophage subtypes. Although the prevalence of myocarditis remained stable between 1990 and 2013 at about 22 per 100,000 people, overall mortality from cardiomyopathy and myocarditis has decreased since 2005. The diagnostic and prognostic value of cardiac magnetic resonance has increased with new, higher-sensitivity sequences. Positron emission tomography has emerged as a useful tool for diagnosis of cardiac sarcoidosis. The sensitivity of endomyocardial biopsy may be increased, especially in suspected sarcoidosis, by the use of electrogram guidance to target regions of abnormal signal. Investigational treatments on the basis of mechanistic advances are entering clinical trials. Revised management recommendations regarding athletic participation after acute myocarditis have heightened the importance of early diagnosis.

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  • The monocyte and macrophage lineage constitute the most abundant immune cell population in the hearts of healthy adults and under myocarditis conditions.

    “The monocyte and macrophage lineage constitute the most abundant immune cell population in the hearts of healthy adults and under myocarditis conditions”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [107]

    The Innate Mechanisms section (page unavailable) describes macrophages and heart-infiltrating monocytic precursors in myocardial inflammation, and the Role of T-Cell Subsets section says T cells are a minority of infiltrating cells in myocarditis. Neither passage establishes that the monocyte–macrophage lineage is the most abundant immune-cell population in myocarditis or in healthy adult hearts. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • In preclinical animal models for myocarditis, monocytes and macrophages were predominant populations in heart infiltrates.

    “in preclinical animal models for myocarditis, monocytes and macrophages were predominant populations in the heart infiltrates”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [107]

    The Innate Mechanisms section describes heart-infiltrating monocytic precursors as a source of acute inflammation and says M2 macrophages predominate during myocardial healing. The Role of T-Cell Subsets section says T cells are a minority of heart-infiltrating cells in mouse myocarditis models. Neither passage establishes that monocytes and macrophages together are the predominant infiltrating populations across preclinical myocarditis models. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • An unnoticed history of viral infection may contribute to the migration and activation of autoreactive T cells in the heart.

    “an unnoticed history of viral infection may contribute to the migration and activation of autoreactive T cells in the heart. 7,10,31,107”

    From Autoimmune Myocarditis, Old Dogs and New Tricks. (2024) · cites this paper as [107]

    The “Role of T-Cell Subsets in Myocarditis” section (page not provided) says that T-cell responses can turn initial myocarditis into an autoimmune response after an infectious agent is cleared, and that dendritic cells promote expansion of autoreactive T cells and heart-specific inflammation. It does not establish that the earlier viral infection was unnoticed or specifically describe migration of autoreactive T cells into the heart. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Authors
Heymans, S., Eriksson, U., Lehtonen, J., & Cooper, L. T.
Affiliations
  • Maastricht University Medical Centre (NL)
  • University of Zurich (CH)
  • Helsinki University Hospital (FI)
  • Mayo Clinic in Florida (US)
Corresponding author
Cooper, Leslie T.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2016-11
Volume
68
Issue
21
Pages
2348-2364
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2016.09.937
OpenAlex
W2555072060
Cited by
359
References
13
Citations by year
2026: 17 · 2025: 38 · 2024: 33 · 2023: 49 · 2022: 55 · 2021: 41 · 2020: 50 · 2019: 36 · 2018: 21 · 2017: 18 · 2016: 1
FWCI
4.47
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • Työväentutkimus Vuosikirja (submittedVersion, other-oa)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
myocarditis, inflammatory cardiomyopathy, dilated cardiomyopathy, cardiac sarcoidosis, microRNA, T cell subsets, macrophages, cardiac magnetic resonance, positron emission tomography, endomyocardial biopsy, viral infection, mortality trends, early diagnosis
MeSH terms
Biopsy, Humans, Immunity, Cellular, Cardiomyopathies, Myocarditis, Myocardium, Prognosis, T-Lymphocytes, Virus Diseases, Global Health, Incidence

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