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DOI: 10.1055/s-0031-1275813
© Georg Thieme Verlag KG Stuttgart · New York
Myokarditis-Diagnostik
Diagnosis of myocarditisPublication History
Publication Date:
12 April 2011 (online)

Zusammenfassung
Die Diagnose der Myokarditis stellt unter ätiopathogenetischen Gesichtspunkten aufgrund der Vielzahl infektiöser sowie nicht-infektiöser Ursachen eine diagnostische Herausforderung dar. Der vorliegende Beitrag behandelt aus kardiopathologischer und infektiologischer Sicht die morphologischen und molekularpathologischen Befunde der am häufigsten vorkommenden infektiösen Myokarditis, die zumeist viral bedingt ist, in Abgrenzung von immunologisch bedingten, nicht-infektiösen Myokarditiden. Eine klinisch relevante Diagnose der Myokarditis gelingt nur durch das konsequente Zusammenführen von klinischen, histologischen, immunhistologischen und molekularbiologischen Befunden.
Abstract
The diagnosis of myocarditis is still a major challenge in clinical cardiology due to the variety of infectious and non-infectious disease entities. The present review summarizes from the point of view of cardiopathology and infectious medicine morphological and molecular pathological findings in myocardial biopsies of patients with infectious myocarditis, most commonly induced by viral infections, in addition to non-infectious myocarditis mediated by immune processes. A clinical relevant diagnosis of myocarditis is achieved only by integration of clinical, histological, immunohistological and molecular biological findings.
Schlüsselwörter
In-situ-Hybridisierung - Polymerasekettenreaktion - Immunhistologie - infektiöse Myokarditis - nicht-infektiöse Myokarditis
Keywords
in situ hybridization - polymerase chain reaction - immunohistology - infectious myocarditis - non-infectious myocarditis
Literatur
- 1
Bock C T, Klingel K, Kandolf R.
Human parvovirus B19-associated myocarditis.
N Engl J Med.
2010;
362
1248-1249
MissingFormLabel
- 2
Cooper Jr L T.
Myocarditis.
N Engl J Med.
2009;
360
1526-1538
MissingFormLabel
- 3
Cooper L T, Baughman K L, Feldman A M. et al .
The role of endomyocardial
biopsy in the management of cardiovascular disease.
J
Am Coll Cardiol.
2007;
50
1914-1931
MissingFormLabel
- 4
Duechting A, Tschöpe C, Kaiser H. et al .
Human parvovirus B19 NS1 protein modulates
inflammatory signaling by activation of STAT3/PIAS3 in
human endothelial cells.
J Virol.
2008;
82
7942-7952
MissingFormLabel
- 5
Frustaci A, Russo M A, Chimenti C.
Randomized study on the efficacy of immunosuppressive therapy
in patients with virus-negative inflammatory cardiomyopathy: the
TIMIC study.
Eur Heart J.
2009;
30
1995-2002
MissingFormLabel
- 6
Hammer E, Phong T Q, Steil L. et al .
Viral myocarditis induced by Coxsackievirus
B3 in A.BY/SnJ mice: analysis of changes in the myocardial
proteome.
Proteomics.
2010;
10
1802-1818
MissingFormLabel
- 7
Kandolf R.
Virusätiologie der inflammatorischen Kardiomyopathie.
Dtsch Med Wochenschr.
2004;
129
2187-2192
MissingFormLabel
- 8 Kandolf R Myokarditis und und Kardiomyopathie.. In: Schumacher G, Hess J, Bühlmeyer K Klinische Kinderkardiologie.. Springer Medizin Verlag; 2008: 449-460
MissingFormLabel
- 9 Kandolf R, Pauschinger M Perikarditis and
Myokarditis.. In: Marre R, Mertens T, Trautmann M, Zimmerli W Klinische Infektiologie.. München, Jena: Urban & Fischer; 2008: 360-372
MissingFormLabel
- 10
Kindermann I, Kindermann M, Kandolf R. et al .
Predictors of outcome in patients with
suspected myocarditis.
Circulation.
2008;
118
639-648
MissingFormLabel
- 11
Klingel K, Lang N, Kandolf R, Netz H.
Lymphofollicular myocarditis: an unknown
cause of terminal heart failure.
Eur Heart J.
2010;
31
892
MissingFormLabel
- 12
Lupescu A, Bock C T, Lang P A, Aberle S. et al .
Phospholipase
A2 activity-dependent stimulation of Ca2+ entry by human
parvovirus B19 capsid protein VP1.
J Virol.
2006;
80
11370-11380
MissingFormLabel
- 13
Mahfoud F, Gärtner B, Kindermann M. et al .
Virus serology in patients with suspected
myocarditis: utility or futility?.
Eur Heart J.
2011 Jan 8.;
[Epub ahead of print]
MissingFormLabel
- 14
Mahrholdt H, Wagner A, Deluigi C C. et al .
Presentation, patterns of myocardial damage,
and clinical course of viral myocarditis.
Circulation.
2006;
114
1581-1590
MissingFormLabel
- 15
Szalay G, Sauter M, Hald J, Weinzierl A, Kandolf R, Klingel K.
Sustained nitric oxide synthesis contributes
to immunopathology in ongoing myocarditis attributable to interleukin-10
disorders.
Am J Pathol.
2006;
169
2085-2093
MissingFormLabel
- 16
Trimpert C, Herda L R, Eckerle L G al.
Immunoadsorption in dilated cardiomyopathy:
long-term reduction of cardiodepressant antibodies.
Eur
J Clin Invest.
2010;
40
685-691
MissingFormLabel
- 17
Ukena C, Mahfoud F, Kindermann I, Kandolf R, Kindermann M, Böhm M.
Prognostic electrocardiographic
parameters in patients with suspected myocarditis.
Eur
J Heart Fail.
2011 Jan 14.;
[Epub ahead of print]
MissingFormLabel
- 18
Yilmaz A, Kindermann I, Kindermann M. et al .
Comparative evaluation of left and right
ventricular endomyocardial biopsy: differences in complication rate
and diagnostic performance.
Circulation.
2010;
122
900-909
MissingFormLabel
Prof. Dr. med. Reinhard Kandolf
Abteilung für Molekulare Pathologie
Universitätsklinikum
Tübingen
Liebermeisterstr. 8
72076
Tübingen
Phone: 07071/29-82264
Fax: 07071/29-5334
Email: reinhard.kandolf@med.uni-tuebingen.de