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Current Heart Failure Reports
Published in: Current Heart Failure Reports 2/2014

01-06-2014 | Management of Heart Failure (TE Meyer, Section Editor)

Management of fulminant myocarditis: A diagnosis in search of its etiology but with therapeutic options

Authors: Bernhard Maisch, Volker Ruppert, Sabine Pankuweit

Published in: Current Heart Failure Reports | Issue 2/2014

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Abstract

Fulminant myocarditis is a clinical syndrome with signs of acute heart failure, cardiogenic shock, or life-threating rhythm disturbances in the context of suspected myocarditis. It is not an etiological diagnosis, but may have different underlying causes and pathogenetic processes – viral, bacterial, toxic, and autoreactive. Clinical management of the disease entity at the acute stage involves hemodynamic monitoring in an intensive care unit or similar setting. Rapid routine work-up is mandatory with serial EKGs, echocardiography, cardiac MRI, heart catheterization with endomyocardial biopsy for histology, immunohistology, and molecular analysis for the underlying infection and pathogenesis. Heart failure therapy is warranted in all cases according to current guidelines. For fulminant autoreactive myocarditis, immunosuppressive treatment is beneficial; for viral myocarditis, IVIg can resolve the inflammation, reduce the viral load, and even eradicate the microbial agent. ECMO, IABP, ventricular assist devices, LifeVest, or ICD implantation can bridge to recovery or to heart transplantation.
Literature
1.••
Caforio AL, Pankuweit S, Arbustini E, Arbustini E, Basso C, Gimeno-Blanes J, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013;34(33):2636–48. Excellent state-of-the-art review on all aspects of myocarditis.PubMed
2.
Maisch B, Hufnagel G, Schönian U, Hengstenberg C. The European Study of Epidemiology and Treatment of Cardiac Inflammatory Disease (ESETCID). Eur Heart J. 1995;16(Suppl O):173–5.PubMed
3.
Maisch B, Richter A, Koelsch S, Alter P, Funck R, Pankuweit S. Management of patients with suspected (peri-) myocarditis and inflammatory dilated cardiomyopathy. Herz. 2006;31(9):881–90.PubMed
4.••
Maisch B, Pankuweit S. Standard and etiology-directed evidence-based therapies in myocarditis: state of the art and future perspectives. Heart Fail Rev. 2013;18(6):761–95. Comprehensiv review on etiology and treatment.PubMed
5.••
Maisch B, Pankuweit S. Current treatment options in (peri) myocarditis and inflammatory cardiomyopathy. Herz. 2012;37(6):644–56. Excellent and comprehensive review on etiology and treatment.PubMed
6.
Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O’Connell J, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93:841–2.PubMed
7.
Maisch B, Bültmann B, Factor S, Gröne HJ, Hufnagel G, Kawamura K, et al. World Heart Federation consensus conference‘s definition of inflammatory cardiomyopathy (myocarditis): report from two expert committees on histology and viral cardiomyopathy. Heartbeat. 1999;4:3–4.
8.
Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P, et al. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology working group on myocardialand pericardial disease. Eur Heart J. 2007;29:270–6.PubMed
9.
Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, et al. Contemporary definitions and classification of cardiomyopathies. An American Heart Association Scientific statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcome Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups: and Council on Epidemiology and Prevention. Circulation. 2006;113:1807–16.PubMed
10.
Aretz HT. Myocarditis: the Dallas criteria. Hum Pathol. 1987;18:619–24.PubMed
11.
Cooper LT, Baughman KL, Feldman AM, Frustaci A, Jessup M, Kuhl U, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: a scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation. 2007;116:2216–33. Important international consensus on case-based indications for endomyocardial biopsy.PubMed
12.
Japanese Circulation Society (JCS) Joint Working Group. Guidelines for diagnosis and treatment of myocarditis (JCS 2009). Circ J. 2011;75:734–43.
13.
Leone O, Veinot JP, Angelini A, Baandrup UT, Basso C, Berry G, et al. 2011 consensus statement on endomyocardial biopsy from the Association for European Cardiovascular Pathology and the Society for Cardiovascular Pathology. Cardiovasc Pathol. 2012;21:245–74.PubMed
14.
Maisch B, Noutsias M, Ruppert V, Richter A, Pankuweit S. Cardiomyopathies – classifications, diagnosis, and treatment. Heart Fail Clin. 2012;8:53–78.PubMed
15.
16.
Schulz-Menger J, Maisch B, Abdel-Aty H, Pankuweit S. Integrated biomarkers in cardiomyopathies: cardiovascular magnetic resonance imaging combined with molecular and immunologic markers. A stepwise approach for diagnosis and treatment. Herz. 2007;32:458–72.PubMed
17.
Paulus WJ, Tschöpe C, Sanderson JE, Rusconi C, Flachskampf FA, Rademakers FE, et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28(20):2539–50.PubMed
18.
Liebermann EB, Hutchin GM, Herskowitz A, Rose NR, Baughman KL. Clinico-pathologic description of myocarditis. J Am Coll Cardiol. 1991;18:1617–26.
19.•
Pankuweit S, Moll R, Baandrup U, Portig I, Hufnagel G, Maisch B. Prevalence of the parvovirus B19 genome in endomyocardial biopsy specimens. Hum Pathol. 2003;34:497–503. Broad analysis on viral etiology in cardiomyopathies.PubMed
20.
Doolan A, Langlois N, Semsarian C. Causes of sudden cardiac death in young Australians. Med J Aust. 2004;180:110–22.PubMed
21.
Gravanis MB, Sternby NH. Incidence of myocarditis. A 10-year autopsy study from Malmo, Sweden. Arch Pathol Lab Med. 1991;114:390–2.
22.
Kytö V, Saraste A, Voipio-Pulkki LM, Saukko P. Incidence of fatal myocarditis: a population-based study in Finland. Am J Epidemiol. 2007;165:570–4.PubMed
23.
Shen WK, Edward WD, Hammill SC, Bailey KR, Ballard DJ, Gersh BJ. Sudden unexpected nontraumatic death in 54 young adults: a 30-year population-based study. Am J Cardiol. 1995;76:14–152.
24.
Eckhart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004;141:829–34.
25.
Rasten-Almqvist P, Eksborg S, Rajs J. Myocarditis and sudden infant death syndrome. Apmis. 2002;110:469–80.PubMed
26.
Topaz O, Edwards JE. Pathologic features of sudden death in children, adolescents, and young adults. Chest. 1985;87:476–82.PubMed
27.
Neuspiel DR, Kuller LH. Sudden and unexpected natural death in childhood and adolescence. JAMA. 1985;254:1321–5.PubMed
28.
Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden death in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation. 2009;119:1085–92.PubMed
29.
Pieroni M, Dello Russo A, Marzo F, Pelargonio G, Casella M, Bellocci F, et al. High prevalence of myocarditis mimicking arrhythmogenic right ventricular cardiomyopathy differential diagnosis by electroanatomic mapping-guided endomyocardial biopsy. J Am Coll Cardiol. 2009;53:681–9.PubMed
30.
Blauwet LA, Cooper LT. Myocarditis. Prog Cardiovasc Dis. 2010;52:274–88.PubMed
31.•
Basso C, Calabrese F, Angelini A, Carturan E, Thiene G. Classification and histological, immunohistochemical and molecular diagnosis of inflammatory myocardial disease. Heart Fail Rev. 2013;18:673–81. Important review and classification.PubMed
32.
Blauwet LA, Cooper LT. Idiopathic giant cell myocarditis and cardiac sarcoidosis. Heart Fail Rev. 2014;18:733–46.
33.
Neu N, Rose NR, Beisel KW, Herskowitz A, Gurri-Glass G, Craig SW. Cardiac myosin induces myocarditis in genetically predisposed mice. J Immunol. 1987;139:3630–6.PubMed
34.
Smith SC, Allen PM. Myosin-induced myocarditis is a T cell-mediated disease. J Immunol. 1991;147:2141–7.PubMed
35.
Izumi T, Maisch B, Kochsiek K. Experimental murine myocarditis after immunization with cardiac membranous proteins. Eur Heart J. 1987;8(Suppl J):419–24.
36.
Maisch B, Wittner B, Wiethölter H. Experimental myocarditis in rabbits-cellular effector mechanisms. Eur Heart J. 1987;8(Suppl J):425–32.
37.
Kodama M, Hanawa H, Saeki M, Hosono H, Inomata T, Suzuki K, et al. Rat dilated cardiomyopathy after autoimmune giant cell myocarditis. Circ Res. 1994;75:278–84.PubMed
38.
Mina Y, Rinkevich-Shop S, Konen E, Goitein O, Kushnir T, Epstein FH, et al. Mast cell inhibition attenuates myocardial damage, adverse remodeling, and dysfunction during fulminant myocarditis in the rat. J Cardiovasc Pharmacol Ther. 2013;18(2):152–61.PubMedCentralPubMed
39.••
Pankuweit S, Klingel K. Viral myocarditis: from experimental models to molecular diagnosis in patients. Heart Fail Rev. 2013;18:683–702. Excellent overview from bench to bedside.PubMed
40.
Matsumori A. Lessons learned from experimental myocarditis. Herz. 2012;37:817–21.PubMed
41.
Huber SA, Gauntt CJ, Sakkinen P. Enteroviruses and myocarditis: viral pathogenesis through replication, cytokine induction, and immunopathogenicity. Adv Virus Res. 1999;51:35–68.
42.
Rose NR. Viral damage or ‘molecular mimicry’: placing the blame in myocarditis. Nat Med. 2000;6:631–2.PubMed
43.•
Rose NR. Myocarditis: infection versus autoimmunity. J Clin Immunol. 2009;29:730–7. Critical update by a mentor of cardiac autoimmunity.
44.
Li Y, Heuser JS, Cunningham LC, Kosanke SD, Cunningham MW. Mimicry and antibody-mediated cell signaling in autoimmune myocarditis. J Immunol. 2007;177:8234–40.
45.
Wilmot I, Morales DL, Price JF, Rossano JW, Kim JJ, Decker JA, et al. Effectiveness of mechanical circulatory support in children with acute fulminant and persistent myocarditis. J Card Fail. 2011;17:487–94.PubMed
46.
Mody KP, Takayama H, Landes E, Yuzefpolskaya M, Colombo PC, Naka Y, et al. Acute mechanical circulatory support for fulminant myocarditis complicated by cardiogenic shock. J Cardiovasc Trans Res. 2014;7:156–64.
47.
Saji T, Matsuura H, Hasegawa K, Nishikawa T, Yamamoto E, Ohki H, et al. Comparison of the clinical presentation, treatment and outcome of fulminant and acute myocarditis in children. Circ J. 2012;76:1222–8.PubMed
48.
Kindermann I, Kindermann M, Kandolf R, Klingel K, Bültmann B, Müller T, et al. Predictors of outcome in patients with suspected myocarditis. Circulation. 2008;118:639–64.PubMed
49.
Mahrholdt H, Goedecke C, Wagner A, Meinhardt G, Athanasiadis A, Vogelsberg H, et al. Cardiovascular magnetic resonance assessment of human myocarditis: a comparison to histology and molecular pathology. Circulation. 2004;109:1250–8.PubMed
50.
Dennert R, Velthuis S, Westermann D, Donker D, Schalla S, van Suylen RJ, et al. Parvovirus-B19-associated fulminant myocarditis successfully treated with immunosuppressive and antiviral therapy. Antivir Ther. 2010;15(4):681–5.PubMed
51.
George CL, Ameduri RK, Reed RC, Dummer KB, Overmann DM, St. Louis JD. Long-term use of ventricular assist device as a bridge to recovery in acute fulminant myocarditis. Ann Thorac Surg. 2013;94:359–60.
52.
Ashrafpoor G, Andreoletti L, Bruneval P, Macron L, Azarine A, Lepillier A, et al. Fulminant human herpesvirus 6 myocarditis in an immunocompetent adult. Role of cardiac magnetic resonance in a multidisciplinary approach. Circulation. 2013;128:e445–7.PubMed
53.
Hakacova N, Klingel K, Kandolf R, Engdahl E, Fogdell-Hahn A, Higgins T. First therapeutic use of Artesunate in treatment of human herpesvirus 6B myocarditis in a child. J Clin Virol. 2013;57(2):157–60.PubMed
54.
Leveque N, Boulagnon C, Brasselet C, Lesaffre F, Boutolleau D, Metz D, et al. A fatal case of Human Herpesvirus 6 chronic myocarditis in an immunocompetent adult. J Clin Virol. 2011;52(2):142–5.PubMed
55.
Mavrogeni S, Bratis K, Terrovitis J, Tsagalou E, Nanas J. Fulminant myocarditis. Can cardiac magnetic resonance predict evolution to heart failure? Int J Cardiol. 2012;159:e37–8.PubMed
56.
Feng WH, Lin TH, Hsieh CC, Voon WC, Lai WT, Sheu SH, et al. Fulminant myocarditis complicated with obstructive ST-elevation myocardial infarction–a rare case report. Am J Emerg Med. 2013;31:635.e1–3.
57.
Saikia UN, Mishra B, Sharma M, Nada R, Radotra BD. Disseminated coxsackievirus B fulminant myocarditis in an immunocompetent adult: a case report. Diagn Microbiol Infect Dis. 2014;78(1):98–100.PubMed
58.
Sellier-Leclerc AL, Belli E, Guérin V, Dorfmüller P, Deschenes G. Fulminant viral myocarditis after rituximab therapy in pediatric nephritic syndrome. Pediatr Nephrol. 2013;28:1875–9.PubMed
59.
Barbandi M, Cordero-Reyes A, Orrego CM, Torre-Amione G, Seethamraju H, Estep J. A case series of reversible acute cardiomyopathy associated with H1N1 influenza infection. Methodist Debakey Cardiovasc J. 2012;8(1):42–5.PubMedCentralPubMed
60.
Bratincsak A, El-Said HG, Bradley JS, Shayan K, Grossfeld PD, Cannavino CR. Fulminant myocarditis associated with pandemic H1N1 influenza A virus in children. J Am Coll Cardiol. 2010;55(9):928–9.PubMed
61.
Cabral M, Brito MJ, Conde M, Oliveira M, Ferreira GC. Fulminant myocarditis associated with pandemic H1N1 influenza A virus. Rev Port Cardiol. 2012;31(7–8):517–20.PubMed
62.
Chacko B, Peter JV, Pichamuthu K, Ramakrishna K, Moorthy M, Karthik R, John G. Cardiac manifestations in patients with pandemic (H1N1) 2009 virus infection needing intensive care. J Crit Care 2011 (published online only)
63.
Gross ER, Gander JW, Reichstein A, Cowles RA, Stolar CJ, Middlesworth W. Fulminant pH1N1-09 influenza-associated myocarditis in pediatric patients. Pediatr Crit Care Med. 2011;12(2):e99–e101.PubMed
64.
Haessler S, Paez A, Rothberg M, Higgins T. 2009 pandemic H1N1-associated myocarditis in a previously healthy adult. Clin Microbiol Infect. 2011;17(4):572–4.PubMed
65.
Khouzam RN, Parizianu C, Hafiz AM, Chawla S, Schwartz R. Fulminant myocarditis associated with novel H1N1 influenza A. Heart Lung. 2011;40(6):566–8.PubMed
66.
Komai T, Nakazawa G, Asai S, Ikari Y. Fatal fulminant myocarditis associated with novel influenza A(H1N1) infection. Eur Heart J. 2011;32:283.PubMed
67.
Liao YC, Hsieh YC, Chang WC, Huang JL, Ting CT, Wu TJ. Fulminant myocarditis in an adult with 2009 pandemic influenza A(H1N1 influenza) infection. J Chin Med Assoc. 2011;74:130–3.PubMed
68.
Martin SS, Hollingsworth CL, Norfolk SG, Wolfe CR, Hollingsworth JW. Reversible cardiac dysfunction associated with pandemic 2009 influenza A (H1N1). Chest. 2010;137:1195–7.PubMedCentralPubMed
69.
Mohite PN, Popov AF, Bartsch A, Zych B, Dhar D, Moza A, et al. Successful treatment of novel H1N1 influenza related fulminant myocarditis with extracorporeal life support. J Cardiothorac Surg. 2011;6:164–5.PubMedCentralPubMed
70.
Morimoto R, Sone T, Tsuboi H, Mukawa H, Morishima I, Uesugi M, et al. A case of fulminant myocarditis associated with novel H1N1 influenza successfully treated by percutaneous cardiopulmonary support system. JC Cases. 2010;2:105–10.
71.
Takeuchi I, Imaki R, Inomata T, Soma K, Izumi T. MRI is useful for diagnosis of H1N1 fulminant myocarditis. Circ J. 2010;74(12):2758–9.PubMed
72.
Ukimura A, Izumi T, Matsumori A. A national survey on myocarditis associated with the 2009 influenza A (H1N1) pandemic in Japan. Circ J. 2010;74:2193–9.PubMed
73.
Ukimura A, Satomi H, Ooi Y, Kanzaki Y. Myocarditis associated with influenza A H1N1pdm2009 (Review). Influenza Res Treat. 2012:351979. doi: 10.​1155/​2012/​351979. Epub 2012 Dec 17.
74.
Estabragh ZR, Mamas MA. The cardiovascular manifestations of influenza: a systematic review. Int J Cardiol. 2013;167(6):2397–407.PubMed
75.
Guarner J, Paddock CD, Shieh WJ, Packard MM, Patel M, Montague JL, et al. Histopathologic and immunohistochemical features of fatal influenza virus infection in children during the 2003–2004 season. Clin Infect Dis. 2006;43:132–40.PubMed
76.
Kumar K, Guirgis M, Zieroth S, Lo E, Menkis AH, Arora RC, et al. Influenza myocarditis and myositis: case presentation and review of the literature. Can J Cardiol. 2011;27:514–22.PubMed
77.
Mamas MA, Fraser D, Neyses L. Cardiovascular manifestations associated with influenza virus infection. Int J Cardiol. 2008;130:304–9.PubMed
78.
Onitsuka H, Imamura T, Miyamoto N, Shibata Y, Kashiwagi T, Ayabe T, et al. Clinical manifestations of influenza A myocarditis during the influenza epidemic of winter 1998–9. J Cardiol. 2001;37:315–23.PubMed
79.
Pan HY, Yamad H, Chida J, Wang S, Yano M, Yao M, et al. Up-regulation of ectopic trypsins in the myocardium by influenza A virus infection triggers acute myocarditis. Cardiovasc Res. 2011;89(3):595–603.PubMedCentralPubMed
80.
Skhirtladze K, Zimpfer D, Zuckermann A, Dworschak M. Influenza A-induced cardiogenic shock requiring temporary ECMO support and urgent heart transplantation. Thorac Cardiovasc Surg. 2012;60:293–4.PubMed
81.
Frank H, Wittekind C, Liebert UG, Siekmeyer M, Siekmeyer W, Schuster V, et al. Lethal influenza B myocarditis in a child and review of the literature for pediatric age groups. Infection. 2010;38:231–5.PubMed
82.
Taremi M, Amoroso A, Nace HL, Gilliam BL. Influenza B-induced refractory cardiogenic shock: a case report. BMC Infect Dis. 2013;13:452–5.PubMedCentralPubMed
83.
Kalimuddin S, Sessions OM, Hou Y, Ooi EE, Sim D, Cumaraswamy S, et al. Successful clearance of human parainfluenza virus type 2 viraemia with intravenous ribavirin and immunoglobulin in a patient with acute myocarditis. J Clin Virol. 2013;56(1):37–40.PubMed
84.
Daniel RAF, Silva AR, Neppelenbroek VBS, Feres O, Bestetti RB. Fulminant myocarditis and viral infection. J Clin Virol. 2013;58:1–3.PubMed
85.
Hebert MM, Yu C, Towbin JA, Rogers BB. Fatal Epstein-Barr virus myocarditis in a child with repetitive myocarditis. Pediatr Pathol Lab Med. 1995;15:805–12.PubMed
86.
Wilson PA, Tierney L, Lai K, Graves S. Queensland tick typhus: three cases with unusual clinical feature. Intern Med J. 2013;43(7):823–5.PubMed
87.
Garcia NS, Castelo JS, Ramos V, Rezende GS, Perira FE. Frequency of myocarditis in cases of fatal meningococcal infection in children: observations on 31 cases studied at autopsy. Rev Soc Bras Med Trop. 1999;32(5):517–22.PubMed
88.
Shrestha P, Shrestha NK, Giri S. Rapid recovery following fulminant meningococcemia complicated by myocarditis in a 15-year-old Nepalese girl: a case report. Int Med Case Rep J. 2013;6:3–36.
89.
Taldir G, Parize P, Arvis P, Faisy C. Acute right-sided heart failure caused by Neisseria meningitidis. J Clin Microbiol. 2013;51(1):363–5.PubMedCentralPubMed
90.
91.
Caforio AL, Calabrese F, Agelini A, Tona F, Vinci A, Bottaro S, et al. A prospective study of biopsy-proven myocarditis: prognostic relevance of clinical and aetiopathogenetic features at diagnosis. Eur Heart J. 2007;28(11):1326–33.PubMed
92.
Kindermann I, Barth C, Mahfoud F, Ukena C, Lenski M, Yilmaz A, et al. Update on myocarditis. J Am Coll Cardiol. 2012;59(9):779–92.PubMed
93.
Weiss TW, Stensaeth KH, Eritsland J. Myocarditis in a juvenile patient with influenza A virus infection. Eur Heart J. 2010;31(3):277.PubMed
94.
Yajima T, Knowlton KU. Viral myocarditis: from the perspective of the virus. Circulation. 2009;119:2615–24.PubMed
95.
Yoshimizu N, Tominaga T, Ito T, Nishida Y, Wada Y, Sohmiya K, et al. Repetitive fulminant Influenza myocarditis requiring the use of circulatory assist device. Intern Med. 2014;53:109–14.PubMed
96.
Choi JO, Yun SH, Sung K, Lee YT, Park JI, Ju ES, et al. Thioredoxin, adiponectin and clinical course of acute fulminant myocarditis. Heart. 2011;97:1067–73.PubMed
97.
Nishii M, Inomata T, Takehana H, Takeuchi I, Nakano H, Koitabashi T, et al. Serum levels of interleukin-10 on admission as a prognostic predictor of human fulminant myocarditis. J Am Coll Cardiol. 2004;44:1292–7.PubMed
98.
Tanawuttiwat T, Trachtenberg BH, Hershberger RE, Hare JM, Cohen MG. Dual percutaneous mechanical circulatory support as a bridge to recovery in fulminant myocarditis. ASAIO J. 2011;57(5):477–9.PubMed
99.
Larsen BT, Maleszewski JJ, Edwards WD, Cooper Jr LT, Sobonya RE, Thompson VE, et al. Atrial giant cell myocarditis: a distinctive clinicopathologic entity. Circulation. 2013;127(1):39–47.PubMed
100.
Hufnagel G, Maisch B, Pfeifer U. Immunhistologic investigations in suspected cardiac sarcoidosis. Eur Heart J. 1987;8(Suppl J):59–62.
101.
Maisch B, Selmayer N, Brugger E, Ertl G, Eiulles C, Heinrich J, et al. Cardiac sarcoidosis–clinical and immunoserologic studies. Eur Heart J. 1987;8(Suppl J):63–71.
102.
Schoppet M, Pankuweit S, Moll R, Maisch B. Images in cardiovascular medicine. Phenotype of infiltrating T lymphocytes in cardiac sarcoidosis. Circulation. 2002;105(12):e67–8.PubMed
103.
Adamson R, Yazici Y, Katz ES, Greisman SG, Steiger D. Fatal acute necrotizing eosinophilic myocarditis temporally related to use of adalimumab in a patient with relapsing polychondritis. J Clin Rheumatol. 2013;19(7):386–9.PubMed
104.
Bourgeois GP, Cafardi JA, Groysman V, Pamboukian SV, Kirklin JK, Andea AA, et al. Fulminant myocarditis as a late sequelae of DRESS-2 cases. J Am Acad Dermatol. 2011;65(4):889–90.PubMedCentralPubMed
105.
Lo MH, Huang CF, Chag LS, Kuo HC, Chien SJ, Lin IC, et al. Drug reaction with eosinophilia and systemic symptoms syndrome associated myocarditis: a survival experience after extracorporeal membrane oxygenation support. J Clin Pharm Ther. 2013;38(2):172–4.PubMed
106.
Frustaci A, Russo MA, 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(16):1995–2002.PubMed
107.
Kamal FA, Watanabe K, Ma M, Abe Y, Elbarbary R, Kodama M, et al. A novel phenylpyridazinone, T-3999, reduces the progression of autoimmune myocarditis to dilated cardiomyopathy. Heart Vessels. 2010;26:81–90.PubMed
108.
Maisch B, Kölsch S, Hufnagel G, Funck RC, Ruppert V, Pankuweit S for the ESETCID Investigators, Orlando 2011, AHA Congress, Abstract
109.
Ağaç MT, Akyüz AR, Acar Z, Erkan H, Vatan B. Massive multi-chamber heart thrombosis as a consequence of acute fulminant myocarditis complicated with fatal ischaemic stroke. Eur J Echocardiogr. 2011;12(11):885. doi:10.​1093/​ejechocard/​jer164.PubMed
110.
Amabile N, Fraisse A, Bouvenot J, Chetaille P, Ovaert C. Outcome of acute fulminant myocarditis in children. Heart. 2006;92(9):1269–73.PubMedCentralPubMed
111.
Asaumi Y, Yasuda S, Morii I, Kakuchi H, Otsuka Y, Kawamura A, et al. Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation. Eur Heart J. 2005;26(20):2185–92.PubMed
112.
Aoyama N, Izumi T, Hiramori K, Isobe M, Kawana M, Hiroe M, et al. National survey of fulminant myocarditis in Japan: therapeutic guidelines and long-term prognosis of using percutaneous cardiopulmonary support for fulminant myocarditis (special report from a scientific committee). Circ J. 2002;66:133–44.PubMed
113.
Berte B, Eyskens B, Meyfroidt G, Willems R. Bidiretional ventricular tachycardia in fulminant myocarditis. Europace. 2008;10(6):767–8.PubMed
114.
Bhatt GC, Sankar J, Kushwaha KP. Use of intravenous immunoglobulin compared with standard therapy is associated with improved clinical outcomes in children with acute encephalitis syndrome complicated by myocarditis. Pediatr Cardiol. 2012;33:1370–6.PubMed
115.
Chaparro SV, Badheka A, Marzouka GR, Tanawuttiwat T, Ahmed F, Sacher V, et al. Combined use of Impella left ventricular assist device and extracorporeal membrane oxygenation as a bridge to recovery in fulminant myocarditis. ASAIO J. 2012;58:285–7.PubMed
116.
Chen YS, Yu HY, Huang SC, Chiu KM, Lin TY, Lai LP, et al. Experience and result of extracorporeal membrane oxygenation in treating fulminant myocarditis with shock: what mechanical support should be considered first? J Heart Lung Transplant. 2005;24:81–7.PubMed
117.
Chiu CW, Yen HH, Chiu CC, Chen YC, Siao FY. Prolonged cardiac arrest: successful resuscitation with extracorporeal membrane oxygenation. Am J Emerg Med. 2013;31(11):167.35–6. doi:10.​1016/​j.​ajem.​2013.​06.​040. Epub 2013 Sep 20.
118.
Cho EJ, Hong J, Kang H, Choe JW, Kim SW. Fulminant myocarditis managed with pulsatile extracorporeal life support; use of Twin Pulse Life support. J Cardiothorac Surg. 2011;6:159–63.PubMedCentralPubMed
119.
Duncan BW, Bohn DJ, Atz AM, French JW, Laussen PC, Wessel DL. Mechanical circulatory support for the treatment of children with acute fulminant myocarditis. J Thorac Cardiovasc Surg. 2001;122:440–8.PubMed
120.
Feldman AM, McNamara D. Myocarditis. N Engl J Med. 2000;343:1388–98.PubMed
121.
Felker GM, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Baughman KL, et al. Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol. 2003;36(1):227–32.
122.
Kato S, Morimoto S, Hiramitsu S, Nomura M, Ito T, Hishida H. Use of percutaneous cardiopulmonary support of patients with fulminant myocarditis and cardiogenic shock for improving prognosis. Am J Cardiol. 1999;83:623–5.PubMed
123.
Kato S, Morimoto S, Hiramitsu S, Uemura A, Ohtsuki M, Kato Y, et al. Risk factors for patients developing a fulminant course with acute myocarditis. Circ J. 2004;68:734–9.PubMed
124.
Kawahito K, Murata S, Yasu T, Adachi H, Ino T, Saito M, et al. Usefulness of extracorporeal membrane oxygenation for treatment of fulminant myocarditis and circulatory collapse. Am J Cardiol. 1998;82(7):910–1.PubMed
125.
Lorusso R, Vizzardi E, Pinelli L, Gelsomino S. Posterior reversible encephalopathy syndrome in a patient submitted to extracorporeal membrane oxygenation for acute fulminant myocarditis. Int J Cardiol. 2014;172:e329–e330.PubMed
126.
Mason JW, O’Connell JB, Herskowitz A, Rose NR, McManus BM, Billingham ME, et al. A clinical trial of immunosuppressive therapy for myocarditis. The Myocarditis Treatment Trial Investigators. N Engl J Med. 1995;333:269–75.PubMed
127.
McCarthy RE, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Hare JM, et al. Long-term outcome of fulminant myocarditis as compared with acute/nonfulminant) myocarditis. N Engl J Med. 2000;342:690–5.PubMed
128.
Maejima Y, Yasu T, Kubo N, Kawahito K, Omura N, Katsuki T, et al. Long-term prognosis of fulminant myocarditis rescued by percutaneous cardiopulmonary support device. Circ J. 2004;68(9):829–33.PubMed
129.
Ishida K, Wada H, Sakakura K, Kubo N, Ikeda N, Sugawara Y, et al. Long-term follow-up on cardiac function following fulminant myocarditis requiring percutaneous extracorporeal cardiopulmonary support. Heart Vessels. 2013;28:86–90.PubMed
130.
Furukawa N, Hata M, Sezai A, Niino T, Yoda M, Unosawa S, et al. Successful treatment of fulminant myocarditis with mechanical circulatory support. J Card Surg. 2008;23:570–2.PubMed
131.
Grinda JM, Chevalier P, D’Attellis N, Bricourt MO, Berrebi A, Guibourt P, et al. Fulminant myocarditis in adults and children: biventricular assist device for recovery. Eur J Cardiothorac Surg. 2004;26:1169–73.PubMed
132.
Hare JM, Baughman KL. Fulminant and acute lymphocytic myocarditis: the prognostic value of clinicopathological classification. Eur Heart J. 2001;22:269–70.PubMed
133.
Hsu KH, Chi NH, Yu HY, Wang CH, Huang SC, Wang SS, et al. Extracorporeal membranous oxygenation support for acute fulminant myocarditis: analysis of a single center’s experience. Eur J Cardiothorac Surg. 2011;40(3):682–8.PubMed
134.
Jaroszewski DE, Marranca MC, Pierce CN, Wong RK, Steidley ED, Scott RL, et al. Successive circulatory support stages: a triple bridge to recovery from fulminant myocarditis. J Heart Lung Transplant. 2009;28:984–6.PubMed
135.
Johri AM, Barake W, Crawford B, Turashvili G, Rossiter J, Evans GA. The velvet myocardium: potential harbinger of death in acute myocarditis? Can J Cardiol. 2013;29(12):1742.e25–7. doi:10.​1016/​j.​cjca.​2013.​09.​007.
136.
Kodama M, Oda H, Okabe M, Aizawa Y, Izumi T. Early and long-term mortality of the clinical subtypes of myocarditis. Jpn Circ J. 2001;65:961–4.PubMed
137.
Lee CH, Tsai WC, Hsu CH, Liu PY, Lin LJ, Chen JH. Predictive factors of a fulminant course in acute myocarditis. Int J Cardiol. 2006;109(1):142–5.PubMed
138.
Lee SH, Choi SA, Choi JH, Kim CW, Shin HJ, Oh JH. Recurrent fulminant myocarditis associated with diffuse large B-cell lymphoma. Int J Cardiol. 2013;164:e7–8.PubMed
139.
140.
Mirabel M, Luyt CE, Leprince P, Trouillet JL, Léger P, Pavie A, et al. Outcomes, long-term quality of life, and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support. Crit Care Med. 2011;39(5):1029–35.PubMed
141.
Moreels M, Delforge ML, Renard M. Fulminant myocarditis with dramatic response to corticoids. Acta Cardiol. 2010;65(1):97–9.PubMed
142.
Morgera T, Di Lenarda A, Dreas L, Pinamonti B, Humar F, Bussani R, et al. Electrocardiography of myocarditis revisited: clinical and prognostic significance of electrocardiographic changes. Am Heart J. 1992;124:455–67.PubMed
143.
Nakashima H, Umeyama Y, Minami K. Successive immunosuppressive treatment of fulminant myocarditis that is refractory to mechanical circulatory support. Am J Case Rep. 2013;14:116–9.PubMedCentralPubMed
144.
145.
Okai I, Inoue K, Maruyama M, Maruyama S, Komatsu K, Nishizawa H, et al. Transbrachial intra-aortic balloon pumping for a patient with fulminant myocarditis. Heart Vessels. 2012;27:639–42.PubMed
146.
Oshima K, Kunimoto F, Hinohara H, Hayashi Y, Hirato J, Tajima Y, et al. Fulminant myocarditis treated with percutaneous cardiopulmonary support system (PCPS). Ann Thorac Cardiovasc Surg. 2008;14:75–80.PubMed
147.
Rajagopal SK, Almond CS, Laussen PC, Rycus PT, Wypij D, Thiagarajan RR. Extracorporeal membrane oxygenation for the support of infants, children, and young adults with acute myocarditis: a review of the Extracorporeal Life Support Organization registry. Crit Care Med. 2010;38:382–7.PubMed
148.
Ryu DR, Heo JW, Lee S-H, Lee W, Choi JW, Kim HY, et al. Fulminant myocarditis. The role of cardiac magnetic resonance imaging. Int J Cardiol. 2013;168:e358–9.
149.
Sasaki H, Kawai A, Kurosawa H. Mechanical support for patients with fulminant myocarditis and respiratory failure. J Card Surg. 2008;23:526–7.PubMed
150.
Takehana H, Inomata T, Kuwao S, Nakahata J, Sasaki T, Nishii M, et al. Recurrent fulminant viral myocarditis with a short clinical course. Circ J. 2003;67:646–8.PubMed
151.
Teele SA, Allan CK, Laussen PC, Newburger JW, Gauvreau K, Thiagarajan RR. Management and outcomes in pediatric patients presenting with acute fulminant myocarditis. J Pediatr. 2011;158:638–43.PubMed
152.
Touze JE, Debonne JM, Scheiner C, Vaillant A, Sans P, Van de Walle JP, et al. Acute necrotizing eosinophilic myocarditis. Favorable clinical course after heart transplantation. Presse Med. 1992;28(12):565–8.
153.
Unosawa S, Hata M, Sezai A, Niino T, Yoshitake I, Shimura K, et al. Successful management of fulminant myocarditis with left ventricular assist device: report of a severe case. Ann Thorac Cardiovasc Surg. 2010;16(1):48–51.PubMed
154.
Vollroth M, Barten MJ, Mohr FW, Garbade J. Biventricular Levitronix CentriMag Assist Device: A “bridge to recovery” solution in patients with acute fulminant myocarditis. Case Rep Surg 2012; Article ID 907490; 2 pages, doi:10.​1155/​2012/​907490.
155.
Wang Q, Pan W, Shen L, Wang X, Xu S, Chen R, et al. Clinical features and prognosis in Chinese patients with acute fulminant myocarditis. Acta Cardiol. 2012;67(5):571–6.PubMed
156.
Wu ET, Huang SC, Chen YS, Wang JK, Wu MH, Ko WJ. Children with fulminant myocarditis rescued with extracorporeal membrane oxygenation. Heart. 2006;92:1325–6.PubMedCentralPubMed
157.
Kühl U, Pauschinger M, Noutsias M, Schultheiss HP. High prevalence of viral genomes and multiple viral infections in the myocardium of adults with “idiopathic” left ventricular dysfunction. Circulation. 2005;11:887–93.
158.
Modrow S. Parvovirus B19: the causative agent of dilated cardiomyopathy or a harmless passenger of the human myocardium? Ernst Schering Res Found Work. 2006;55:63–82.
159.
Koepsell SA, Anderson DR, Radio SJ. Parvovirus B19 is a bystander in adult myocarditis. Cardiovasc Pathol. 2012;21(6):476–81.PubMed
160.
Shioji K, Matsuura Y, Iwase T, Kitaguchi S, Nakamura H, Yodoi J, et al. Successful immunoglobulin treatment for fulminant myocarditis and serial analysis of serum thioredoxin: a case report. Circ J. 2002;66:977–80.PubMed
161.
Lieberman EB, Herskowitz A, Rose NR, Baughman KL. A clinicopathologic description of myocarditis. Clin Immunol Immunopathol. 1993;68:191–6.PubMed
162.
Maisch B, Seferović PM, Ristić AD, Erbel R, Rienmüller R, Adler Y, et al. Guidelines on the diagnosis and management of pericardial diseases executive summary; The Task force on the diagnosis and management of pericardial diseases of the European Society of Cardiology. Eur Heart J. 2004;25(7):587–610.PubMed
163.
Maisch B, Ristić AD, Seferović PM, Tsang TSM. Interventional pericardiology. Heidelberg: Springer; 2011.
164.
McNamara DM, Holubkov R, Starling RC, Dec GW, Loh E, Torre-Amione G, et al. Controlled trial of intravenous immune globulin in recent-onset dilated cardiomyopathy. Circulation. 2001;103(18):2254–9.PubMed
Metadata
Title
Management of fulminant myocarditis: A diagnosis in search of its etiology but with therapeutic options
Authors
Bernhard Maisch
Volker Ruppert
Sabine Pankuweit
Publication date
01-06-2014
Publisher
Springer US
Published in
Current Heart Failure Reports / Issue 2/2014
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-014-0196-6

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