An update on cardiomyopathies: immune-mediated diseases, sarcoidosis, and peripartum and hypertrophic cardiomyopathies during pregnancy

Although ischaemic heart disease is a very common cause of heart failure, particularly that associated with reduced ejection fraction, diseases of the heart muscle and pericardium are also important.1 However, the underlying causes in the latter group of patients are much more variable, and include genetics,2–4 inflammation,5,6 infection,7 and pressure overload,8 among others, and so is their management. In a Position Paper from the ESC Working Group on Myocardial and Pericardial Disease entitled ‘Diagnosis and management of myocardial involvement in systemic immune-mediated diseases:aposition statement of the ESC Working Group on Myocardial and Pericardial Disease’. The authors remind us that the myocardium is a critical target in systemic immune-mediated diseases, even in asymptomatic patients, with negative prognostic implications.9 Inflammatory and degenerative myocardial diseases differ markedly in type and frequency in individual systemic immune-mediated diseases. However, some general considerations and recommendations can nevertheless be made and, as such, the authors provide a first orientation to cardiologists and physicians at large for selecting an appropriate multidisciplinary diagnostic work-up as well as a personalized approach, setting the stage for future controlled studies.