This review highlights the role of inflammation, autoimmune factors, and microcirculation alterations in the pathogenesis of myocarditis, suggesting potential targets for future therapeutic strategies.
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No immediate clinical implications for myocarditis; leaves open validation of autoimmune and microcirculatory targets in prospective trials.
We review recent manuscripts concerning the pathogenesis as well as the treatment of myocarditis. The development of myocarditis is related to inflammatory cell infiltration, progressive and additive focal cellular necrosis, and associated reactive myocardial fibrosis. These processes may be initiated and perpetuated by autoimmune factors, including cytokines, and by alterations in the myocardial microcirculation. This has implications for the development of future therapeutic strategies for patients with myocarditis, strategies that will enable physicians to optimize medical treatment and, hopefully, to improve the prognosis.
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Kishimoto et al. (1994) studied this question.
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