Innovative drug treatments for viral and autoimmune myocarditis.
Myocarditis is a common cause of cardiomyopathy and is thought to account for 25% of all cases in humans. Unfortunately, the disease is difficult to detect clinically before a myopathic process ensues. Management of myocarditis-induced heart failure includes the standard regimen of diuretics, digoxin, angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, and beta-adrenergic blockers. The management of myocarditis itself is dependent on the etiology of the illness. Treatments that are currently under investigation include immunosuppressants, nonsteroidal antiinflammatory agents, immunoglobulins, immunomodulation, antiadrenergics, calcium-channel blockers, angiotensin-converting enzyme inhibitors, nitric oxide inhibitors (e.g., aminoguanidine), and antivirals. Despite advances in treatment, more work needs to be done in the early detection of myocarditis. Additionally, better means need to be established for distinguishing between viral and noninfectious autoimmune forms of the disease, so that appropriate treatment can be instituted.
Frishman
William H
WH
Department of Medicine and Pharmacology, New York Medical College, Valhalla, NY 10595, USA.
O'Brien
Miechelle
M
Naseer
Nauman
N
Anandasabapathy
Sharmila
S
D018674:Adrenergic Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000517:prevention & control*; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D009205:Myocarditis / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014777:Virus Diseases / Q000150:complications / Q000188:drug therapy* / Q000401:mortality
D018674:Adrenergic Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents