Current treatment and immunomodulation strategies in Acute Myocarditis

Author:

Ferone Emma1,Segev Amitai2,Tempo Erika3,Gentile Piero4,Elsanhoury Ahmed567,Baggio Chiara8,Artico Jessica910,Bhatti Prashan111,Scott Paul11,Bobbio Emanuele1213,Merlo Marco8,Ameri Pietro314,Sinagra Gianfranco8,Tschöpe Carsten56715,Bromage Daniel111,Cannata Antonio111

Affiliation:

1. School of Cardiovascular Medicine and Sciences, King’s College L ondon, London, United Kingdom.

2. Cardiovascular Division, Chaim Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel. The Sackler Faculty of Medicine, Tel-Aviv University

3. Department of Internal Medicine, University of Genova, Genova, Italy

4. Ospedale Niguarda Ca’granda, Milan, Italy

5. Berlin Institute of Health (BIH) Center for Regenerative Therapies (BCRT), Berlin, Germany.

6. Department of Cardiology, Angiology, and Intensive Medicine (CVK), German Heart Center at Charite (DHZC), Berlin, Germany.

7. German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany.

8. CardioThoracoVascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina, Trieste, Italy. Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart’ (ERN GUARDHEART)

9. Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London UK

10. Institute of Cardiovascular Science, University College London, UK.

11. King’s College Hospital NHS Foundation Trust, London, UK.

12. Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.

13. Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

14. Cardiovascular Disease Unit, Cardiac, Thoracic and Vascular Department, IRCCS Ospedale Policlinico San Martino, Genova, Italy

15. Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

Abstract

Myocarditis is an inflammatory disease of the myocardium characterized by a great heterogeneity of presentation and evolution. Treatment of myocarditis is often supportive and the evidence for immunosuppression is scarce and debated. Conventional treatment is based on clinical presentation, ranging from conservative to advanced mechanical assist devices. In this setting, immunosuppression and immunomodulation therapies are mostly reserved for patients presenting with major clinical syndromes. In this review, we will summarise the current evidence and strategies for conventional and immunosuppressive treatments for patients presenting with acute myocarditis.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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