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European Heart Journal Advance Access originally published online on June 26, 2009
European Heart Journal 2009 30(16):1936-1939; doi:10.1093/eurheartj/ehp172
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

The heat is off: immunosuppression for myocarditis revisited

Leslie T. Cooper*

Cardiovascular Division, Mayo Clinic, Rochester, MN 55905, USA

accepted 1 June 2008; online publish-ahead-of-print 26 June 2009.

* Corresponding author. Tel: +1 507 284 3680, Fax: +507 266 0228, Email: cooper.leslie@mayo.edu

This editorial refers to ‘Randomized study on the efficacy of immunosuppressive therapy in patients with virus-negative inflammatory cardiomyopathy: the TIMIC study’{dagger}, by A. Frustraci et al., on page 1995

The first 150 words of the full text of this article appear below.

Non-ischaemic, dilated cardiomyopathy (DCM) is an important cause of heart failure and heart transplantation, with a prevalence of 36.5 per 100 000 in the USA.1 Depending on the histological or immunohistological criteria employed, myocarditis is present in ~10–50% of heart biopsy samples taken from patients with acute non-ischaemic DCM.2 When T cell and macrophage number are quantified by immunohistological methods or the definition of myocarditis is broadened to include expression of class II major histocompatability complex antigens and adhesion molecules, myocarditis is present in 40–50% of patients with chronic DCM.3 Of the many known causes of myocarditis, viral infection is perhaps the most important. From 25 to 40% of myocardial samples from patients with chronic, unexplained DCM contain viral genomes.4 Although a host of viruses have been implicated in myocarditis and DCM, viral infection is not always accompanied by inflammation.

Experimental studies in inbred rodents suggest a model . . . [Full Text of this Article]


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J. C. Schultz, A. A. Hilliard, L. T. Cooper Jr, and C. S. Rihal
Diagnosis and Treatment of Viral Myocarditis
Mayo Clin. Proc., November 1, 2009; 84(11): 1001 - 1009.
[Abstract] [Full Text] [PDF]