B Maisch

..A case of active parvo B19-positive myocarditis demonstrates the role of immunoglobulin treatment under these conditions...

..This paper reviews our present knowledge on the humoral immune response in myocarditis and its interplay with the viral agents and the other components of the immune system...

..Pericardiocentesis was enabled by means of the PerDUCER device, facilitated by pericardioscopy...

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..In Parvo B19 associated DCMi therefore dose finding studies and randomized trials are needed...

..This diagnostic algorithm, which we recommend for any form of dilated cardiomyopathy, bears impact on treatment options beyond the mere heart failure therapy that should be instigated anyhow...

..Cardiac surgery with pericardiolysis and (partial) pericardial resection remains the method of choice for symptomatic constrictive pericarditis...

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..In the future, this may have therapeutic implications...

..It is concluded that the diagnostic use of BNP should primarily be directed to assess ventricular wall stress rather than the extent of functional ventricular impairment in LVD...

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..These findings have to be taken into account in future diagnostic and therapeutic studies in the field of cardiomyopathies...

..Infective agents and their adequate diagnosis and treatment are discussed for these clinical entities according to current guidelines and clinical pathways...

..Additionally, a brief overview is presented stating the current knowledge on effector mechanisms of the immune system in myocarditis and dilated cardiomyopathy...

..Whether increased vagal tone may contribute to the protective effect of carvedilol has to be evaluated by further studies...

..Apoptosis thus contributes to cell death in active myocarditis and may play a role not to be neglected in dilated cardiomyopathy. Enteroviruses seem to have anti-apoptotic effects, because no apoptosis at all was found in the myocardium...

..These guidelines are straightforward and feasible for cardiologists as well as specialists in internal medicine and general practicioners. Nevertheless, some points still lack evidence...

..Most likely, deterioration of myocardial work is crucial for the prognosis. It is suggested to include these basic physiological procedures in the clinical assessment of the pump function of the heart...

..A general pathogenic effect on the development of dilated cardiomyopathy is less likely. The mutations may be a sign of increasing stress to the heart, however, thus promoting consecutive damage of mtDNA by initiating a vicious circle...

..It could be assumed that 5-FU toxicity is reversible in the majority of cases when acute complications, e.g., arrhythmias, are resolved...

..Except abstinence, treatment of alcoholic cardiomyopathy is based on the regimen of therapy for heart failure to reduce the size of the dilated heart and to mitigate the symptoms of heart failure...

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..A fiberscope can be used to inspect the pericardium prior to puncture. Based on these procedures, the role of the pericardial space and the presence of pericardial effusion in cardiac regeneration can be assessed...

..Nevertheless, much more progress in the identification of underlying mutations, susceptibility genes and modifier genes is important and indispensable for the development of new etiology orientated forms of therapy...

..Before corticoid treatment is started, a viral or microbial aetiology has to be excluded at the site of cardiac inflammation. This again can only be done by the analysis of cardiac tissue samples...

..g., EF) appear to be secondary. Since an increased wall stress is associated with cardiac dilatation, early diagnosis and treatment could potentially prevent worsening of the outcome...

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..Apoptosis causes loss of contractile cardiomyocytes in inflammatory heart disease. Despite recent examinations, the influence of virus infection on apoptosis remained ill-defined...

..In conclusion, the formation of linear lesions at the isthmus and at the pulmonary veins was successful with the laser and RF. In the trabeculated left atrium and the thick posterior right atrium, only laser ablation was successful...

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..CONCLUSION: Intrapericardial treatment with cisplatin appeared to successfully prevent recurrences of neoplastic pericardial effusion. The treatment was more successful in lung than in breast cancer patients...

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..This approach ensures that at least all of our patients with documented CAD receive the appropriate preventional recommendations and treatment...

..Mitochondrial proteins have been implicated in the pathogenesis of inflammatory heart disease for some years, and in this study we have identified two mitochondrial proteins as relevant antigens in rheumatic heart disease...

..Before a definite judgement on the clinical relevance of these new preventive and therapeutic pacing strategies can be given, the results of these ongoing controlled clinical studies have to be analyzed...

..Cardiac dilatation is associated with impaired pump function, progression of heart failure and electrical instability. Risk of sudden death is associated with a low blood level of n-3 polyunsaturated fatty acids...

..In autoreactive pericarditis intrapericardial instillation of triamcinolone is effective with few side effects. In malignant pericarditis the intrapericardial administration of cisplatin prevents early recurrences...

..These antibodies may develop as a consequence of damage to endocardial cells (thereby exposing intracellular antigen to the immune system) and do not seem to play a role in the pathogenesis of infective endocarditis...

..Such an approach may change the management of these diseases in the future. One of the aims of the study was to reveal the underlying dominant pathophysiological mechanisms in a for deciding on the most approriate therapy...

..The long-term effects of sibutramine treatment on the rates of cardiovascular events and cardiovascular death among subjects at high cardiovascular risk have not been established...

..However, it is unknown whether a change of NT-proBNP plasma levels in the early phase of decompensation might be of additional prognostic value in patients with acute decompensation of heart failure...

..In addition, an overview of the current state of research with regard to the echocardiographic assessment of left ventricular diastolic function will be given...

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..The goal of every diagnostic and therapeutic intervention must be to eradicate the virus and eliminate the inflammatory response to prevent the disease from progressing to terminal cardiac insufficiency...

..Diffuse esophageal spasm is the extracardiac condition that is confused most often with ischemic cardiac chest pain. This pain presents as a deep thoracic pain that may be present over most of the thorax. It may extend down the anterome..

..The increased blood pressure and heart rate normalized after rats were fed a regular chow. We concluded that an excessive caloric intake results in hyperkinetic hypertension that increases the myosin V(1) proportion...

..This case report is a reminder that a varicella infection can cause myocarditis in adults. Early diagnosis and appropriate treatment of this rare form of myocarditis may lead to complete recovery...

..A candidate approach could involve growth factor analogues which are known to induce fibroblast apoptosis when an incomplete growth stimulus persists...

..Further clinical research focused on the pathogenesis and treatment of cardiovascular diseases in cancer patients is warranted to pave the way to guidelines for this nonhomogeneous patient group...

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..Continuous endothelial dysfunction and activation, caused by risk factors and infection, represent the basis for atherogenesis and acute coronary syndromes...

..In stage 1 and 2 DCM diabetic cardiomyopathy is clearly a fact. However, precise determination of to what degree the various underlying pathogenetic processes are responsible for the overall heart failure phenotype remains a fiction...

..In conclusion, an old-fashioned, previously abandoned treatment strategy is currently celebrating its revival...

..The prognostic relevance of this finding, however, was not clear...

..Rotational atherectomy successfully removed parts of the maldeployed stent and resistant arterial wall substance allowing full dilatation of the lesion...

..Although the tumour occupied a large part of the left atrium the patient remained in sinus rhythm and displayed no symptoms...

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..Because these proteins are intracullularly located enzymes, their pathogenetic role as antigens for the autoantibodies remains to be elucidated further...

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..Improvement of left ventricular ejection fraction was present in eight patients (80%), while LV dysfunction persisted in four patients. Our findings support the hypothesis of an underlying autoimmune pathomechanism in this rare disease...

..The most frequent cardiotropic viruses detected by endomyocardial biopsy are Parvo B19, enteroviruses, adenoviruses, cytomegalovirus, and less frequently Epstein-Barr virus, and influenza virus...

..This condition should immediately lead to cardiac surgery. Although pericardiectomy is the only treatment for permanent constriction, this procedure is contraindicated when extensive myocardial fibrosis and/or atrophy are demonstrated...

..Although the reason for progression to myocardial failure is not fully understood, postulated mechanisms include persistent viral infection alone or in combination with autoimmune processes...

..The pharmacological effects of ethyl esters are compared with the naturally occurring EPA and DHA triacylglycerols present in fish or fish oils which are of interest in primary prevention of cardiovascular disorders...

..Since viral or inflammatory injury of the heart can also induce a fetal phenotype, metabolic modulators such as etomoxir represent a promising therapeutic approach also for cardiomyopathies with inadequate SERCA2 expression...

..The aim is to help clinicians look beyond generic diagnostic labels in order to reach more specific diagnoses...

..Expression profile analysis using endomyocardial biopsy specimens from patients with cardiomyopathies promises to improve the differential diagnosis of heart failure...

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..Thus, our study identified the DSG2-V55M polymorphism as a novel risk variant for DCM associated with shortened desmosomes of the cardiac intercalated disc...

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..By this approach a new insight in the familial clustering of other autoimmune diseases in patients with DCM and in genetic predisposition can be expected...

..Because PVB19 myocarditis may progress to chronic dilated cardiomyopathy, early diagnosis by endomyocardial biopsy is important to initiate anti-inflammatory treatment...

..This may change the management of the disease in the future. One of the hopes is to discern the underlying dominant mechanism in a given patient to make a decision for the most promising therapy...

..001 vs. controls). In conclusion, myocardial overexpression of antiapoptotic OPG in DCM patients may represent a compensatory mechanism to limit systemic activation of TRAIL in patients with congestive heart disease...

..In conclusion, CSR is associated with depressed systolic RV function and increased RV dimensions in CHF patients. Future studies will show whether optimized treatment of CSR will improve RV function...

..Delivery of normal infants in term after pericardiocentesis or pericardiectomy is expected, whenever natural history of causative disease allows. Pericardiectomy itself is not a contraindication for subsequent successful pregnancies...

..Arrhythmia risk stratification with regard to prophylactic implantable cardioverter-defibrillator therapy is a completely unsolved issue in idiopathic dilated cardiomyopathy (IDC)...

..This raises the question to what extent physical activity in patients with myocarditis, dilated cardiomyopathy or heart failure in general is tolerable...

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..In contrast, left ventricular ejection fraction was significantly lower in patients with versus without MAE (24%+/- 7% vs 31%+/- 10%, P < 0.019. CONCLUSIONS: Neither HRV nor BRS predicted MAE in patients with IDC...

..Previous studies demonstrated cardiac involvement in patients suffering from severe malaria due to P. falciparum. Therefore, we tested the hypothesis that GPI induces apoptosis in cardiomyocytes...

..Drug sensitivity testing is essential. Pericardiectomy is reserved for recurrent effusions or continued elevation of central venous pressure after 4-6 weeks of antituberculous and corticosteroid therapy...

..PVB19 should therefore be recognized as a potential cardiotropic pathogen in patients of all ages...

..To date, considerable controversy exists on the prognostic significance of morphometric endomyocardial biopsy findings in patients with idiopathic dilated cardiomyopathy (IDC)...

..We correlated these clinical findings with the presence of antibodies against hsp70 and the antioxidative capacity of patients' sera...

..SCD-HeFT showed a significant reduction of total mortality in the ICD group, whereas amiodarone did not improve survival...