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Nonnegligible Myocarditis: Insights from 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
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摘要: 2021年9月，Eur Heart J发布了《2021年ESC急慢性心力衰竭诊断与治疗指南》，该版指南对2016年版指南作出重要更新。其中，心肌炎作为心力衰竭的一种特定临床情况应给予重点关注。本文结合我国心肌炎临床诊疗实践，对新版指南中心肌炎部分进行全面解读，以加深临床医师对此类疾病的认识和理解。Abstract: In September 2021, Eur Heart J published the 2021 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure, making important updates to the 2016 version. In the new guidelines, myocarditis is identified as a special clinical condition in heart failure that should be given more attention than before. Based on the current clinical practice of myocarditis management in China, this article aims to provide a comprehensive interpretation of the myocarditis section in the new guidelines, with the hope of improving the diagnosis and treatment of this disease.
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Key words:
- heart failure /
- myocarditis /
- diagnosis /
- therapy
作者贡献：邱露虹负责查阅文献、撰写论文；徐希奇、刘颖娴负责审核及修订论文。利益冲突：所有作者均声明不存在利益冲突 -
[1] McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J, 2021, 42: 3599-3726. [2] Dai H, Lotan D, Much AA, et al. Global, Regional, and National Burden of Myocarditis and Cardiomyopathy, 1990—2017[J]. Front Cardiovasc Med, 2021, 8: 610989. doi: 10.3389/fcvm.2021.610989 [3] Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990—2013: a systematic analysis for the Global Burden of Disease Study 2013[J]. Lancet, 2015, 386: 743-800. [4] Heymans S, Eriksson U, Lehtonen J, et al. The Quest for New Approaches in Myocarditis and Inflammatory Cardiomyopathy[J]. J Am Coll Cardiol, 2016, 68: 2348-2364. doi: 10.1016/j.jacc.2016.09.937 [5] Merken J, Hazebroek M, Van Paassen P, et al. Immunosuppressive Therapy Improves Both Short- and Long-Term Prognosis in Patients With Virus-Negative Nonfulminant Inflammatory Cardiomyopathy[J]. Circ Heart Fail, 2018, 11: e004228. doi: 10.1161/CIRCHEARTFAILURE.117.004228 [6] Das M, Bristow MR, Chung MK. The Essential Vulner-ability of Human Cardiac Myocytes to SARS-CoV-2[J]. JACC Basic Transl Sci, 2021, 6: 346-349. doi: 10.1016/j.jacbts.2021.02.010 [7] Grün S, Schumm J, Greulich S, et al. Long-term follow-up of biopsy-proven viral myocarditis: predictors of mortality and incomplete recovery[J]. J Am Coll Cardiol, 2012, 59: 1604-1615. doi: 10.1016/j.jacc.2012.01.007 [8] Yeung C, Baranchuk A. Diagnosis and Treatment of Lyme Carditis: JACC Review Topic of the Week[J]. J Am Coll Cardiol, 2019, 74: 717-726. doi: 10.1016/j.jacc.2019.08.865 [9] Moslehi JJ, Salem JE, Sosman JA, et al. Increased reporting of fatal immune checkpoint inhibitor-associated myocarditis[J]. Lancet, 2018, 391: 933. [10] Palaskas N, Lopez-Mattei J, Durand JB, et al. Immune Checkpoint Inhibitor Myocarditis: Pathophysiological Characteristics, Diagnosis, and Treatment[J]. J Am Heart Assoc, 2020, 9: e013757. [11] Caforio AL, Pankuweit S, Arbustini E, 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[J]. Eur Heart J, 2013, 34: 2636-2648, 2648a-2648d. [12] Staudt A, Schäper F, Stangl V, et al. Immunohistological changes in dilated cardiomyopathy induced by immunoadsorption therapy and subsequent immunoglobulin substitution[J]. Circulation, 2001, 103: 2681-2686. [13] Ammirati E, Cipriani M, Lilliu M, et al. Survival and Left Ventricular Function Changes in Fulminant Versus Nonfulmi-nant Acute Myocarditis[J]. Circulation, 2017, 136: 529-545. [14] Gannon MP, Schaub E, Grines CL, et al. State of the art: Evaluation and prognostication of myocarditis using cardiac MRI[J]. J Magn Reson Imaging, 2019, 49: e122-e131. [15] Felker GM, Thompson RE, Hare JM, et al. Underlying causes and long-term survival in patients with initially unexplained cardiomyopathy[J]. N Engl J Med, 2000, 342: 1077-1084. -
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