-
摘要: 心肌炎后心肌病属于获得性扩张型心肌病，主要是由于机体免疫炎症反应网络以及该网络决定的由多种细胞因子组成的心脏局部微环境的异常，影响着后续的组织修复过程，最终导致心肌组织的纤维化。临床诊断需要有心肌炎自然演变为心肌病的病史或者肠道病毒RNA的持续表达或血清免疫学标志物抗心肌自身抗体阳性的证据。除了常规心力衰竭治疗方法外，针对其病因和发病机制的特异性治疗也需考虑。Abstract: Post-myocarditis cardiomyopathy belongs to acquired dilated cardiomyopathy. The main cause is the immune inflammatory response and a variety of cytokines affecting tissue repair, which eventually leads to myocardial fibrosis. Clinical diagnosis requires a history of myocarditis spontaneously evolving to cardiomyopathy, persistent expression of enterovirus RNA, or positive anti-myocardial autoantibodies. In addition to conventional heart failure treatment, specific treatments for etiology and pathogenesis need to be considered.
-
Key words:
- viral myocarditis /
- dilated cardiomyopathy /
- treatments /
- pathogenesis
-
-
[1] Maron BJ, Udelson JE, Bonow RO, et al. Eligibility and disqualifification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 3: hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and other cardiomyopathies, and myocarditis: a scientifific statement from the American Heart Association and American College of Cardiology[J]. Circulation, 2015, 132(22): E273-E280.
[2] Heymans S, Eriksson U, Lehtonen J, et al. The quest for new approachesin myocarditis and inflammatory cardiomyopathy[J]JACC, 2016, 68(21): 2348-2364.
[3] Sagar S, Liu PP, Cooper LT Jr. Myocarditis[J]. Lancet, 2012, 379(9817): 738-747. doi: 10.1016/S0140-6736(11)60648-X
[4] 中华医学会心血管病学分会, 中国心肌炎心肌病协作组. 中国扩张型心肌病诊断和治疗指南[J]. 临床心血管病杂志, 2018, 34(5): 421-434. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB201805001.htm
[5] Sorokin L. The impact of the extracellular matrix on inflammation[J]. Nat Rev Immunol, 2010, 10(10): 712-723. doi: 10.1038/nri2852
[6] Wu B, Li J, Ni H, et al. TLR4 Activation Promotes the Progression of Experimental Autoimmune Myocarditis to Dilated Cardiomyopathy by Inducing Mitochondrial Dynamic Imbalance[J]. Oxid Med Cell Longev, 2018, 2018: 3181278.
[7] Lin L, Zhang M, Yan R, et al. Inhibition of Drp1 attenuates mitochondrial damage and myocardial injury in Coxsackievirus B3 induced myocarditis[J]. Biochem Biophys Res Commun, 2017, 484(3): 550-556. doi: 10.1016/j.bbrc.2017.01.116
[8] Raimondi F, Iserin F, Raisky O, et al. Myocardial inflammation on cardiovascular magnetic resonance predicts left ventricular function recovery in children with recent dilated cardiomyopathy[J]. Eur Heart J Cardiovasc Imaging, 2015, 16(7): 756-762.
[9] 杨英珍. 病毒性心脏病[M]. 上海: 上海科技出版社, 2001.
[10] Schultheiss HP, Piper C, Sowade O, et al. Betaferon in chronic viral cardiomyopathy(BICC)trial: Effects of interferon-a treatment in patients with chronic viral cardiomyopathy[J]. Clin Res Cardiol, 2016, 105(9): 763-773. doi: 10.1007/s00392-016-0986-9
[11] Tschöpe C, Cooper LT, TORRE-AMIONEG, et al. Management of Myocarditis-Related Cardiomyopathy in Adults[J]. Circ Res, 2019, 124(11): 1568-1583. doi: 10.1161/CIRCRESAHA.118.313578
-
计量
- 文章访问数: 1459
- PDF下载数: 789
- 施引文献: 0
下载: