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Biology
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New Advances and Insights in Inflammatory Cardiomyopathy
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New Advances and Insights in Inflammatory Cardiomyopathy

A special issue of Biology (ISSN 2079-7737).

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 9342

Special Issue Editors

Dr. Krzysztof Ozierański

E-Mail Website
Guest Editor
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Interests: inflammatory cardiomyopathy; dilated cardiomyopathy; myocarditis; hypertrophic cardiomyopathy; arrhythmogenic cardiomyopathy; heart failure; personalized medicine; endomyocardial biopsy; viral myocardial infection
Dr. Agata Tymińska

E-Mail Website
Guest Editor
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
Interests: cardiac magnetic resonance; echocardiography; cardiomyopathies; inflammatory cardiomyopathy; heart failure; myocarditis; biomarkers
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Alida L. P. Caforio

E-Mail Website
Guest Editor
Cardiology, Department of Cardiac Thoracic Vascular Sciences and Public Health, Head Cardioimmunology and Thrombosis Laboratory, University of Padova, Padova, Italy
Interests: cardiomyopathies; inflammatory cardiomyopathy; heart failure; myocarditis; anti-heart autoantibody

Special Issue Information

Dear Colleagues,

Inflammatory cardiomyopathy is a heart disease induced by infectious or noninfectious causes, frequently triggering immune-mediated pathologic mechanisms that lead to myocardial structural and functional compromise. Due to the large variability of clinical presentation, an unpredictable course of the disease, and a lack of established causative treatments, inflammatory cardiomyopathy is a major diagnostic and therapeutic challenge in cardiology. What is more, an increasing incidence of inflammatory cardiomyopathy has been observed in recent decades. 

Recent years have seen important progress in available noninvasive diagnostic methods, including biomarkers, serum antiheart autoantibodies, microRNAs, speckle tracking echocardiography, cardiac magnetic resonance T1 and T2 tissue mapping, and positron emission tomography, which may help to distinguish the underlying pathogenesis and refine the diagnostic workup of inflammatory cardiomyopathy. 

Nevertheless, there is a significant knowledge gap regarding the pathogenesis of inflammatory cardiomyopathy as well as individualized diagnostic and treatment concepts. In particular, new biomarkers as well as disease-specific diagnostic and therapeutic strategies are required to adequately manage patients with suspected inflammatory cardiomyopathy. It is also increasingly recognized that personalized management should also include the implementation of disease-specific therapies.

For this Special Issue, we encourage the submission of manuscripts on any aspect of the pathophysiologic mechanisms, diagnosis (such as novel biomarkers, advances in cardiac imaging modalities, and endomyocardial biopsy), and treatment of inflammatory cardiomyopathy, including experimental, translational, and clinical research. We accept reviews, short communications, methodology papers, and full-size research papers with a focus on the following aspects:

  • Novel effective diagnostic and/or therapeutic strategies of inflammatory cardiomyopathy.
  • Approaches to better classify the phenotypes and/or etiologies of inflammatory cardiomyopathy.
  • New genes, pathomechanisms, and potential drug targets for particular phenotypes and/or etiologies of inflammatory cardiomyopathy.

Dr. Krzysztof Ozierański
Dr. Agata Tymińska
Prof. Dr. Alida L. P. Caforio
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory cardiomyopathy
  • dilated cardiomyopathy
  • myocarditis
  • heart failure
  • immunosuppressive treatment
  • myocardial inflammation
  • personalized medicine
  • endomyocardial biopsy
  • viral myocardial infection
  • biomarkers

Published Papers (3 papers)

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Research

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16 pages, 1949 KiB  
Article
Cardiac Magnetic Resonance Findings in Patients Recovered from COVID-19 Pneumonia and Presenting with Persistent Cardiac Symptoms: The TRICITY-CMR Trial
by Dagmara Wojtowicz, Karolina Dorniak, Marzena Ławrynowicz, Piotr Wąż, Jadwiga Fijałkowska, Dorota Kulawiak-Gałąska, Joanna Rejszel-Baranowska, Robert Knut, Maciej Haberka, Edyta Szurowska and Marek Koziński
Biology 2022, 11(12), 1848; https://doi.org/10.3390/biology11121848 - 18 Dec 2022
Cited by 5 | Viewed by 1988
Abstract
The prevalence and clinical consequences of coronavirus disease 2019 (COVID-19)-related non-ischemic cardiac injury are under investigation. The main purpose of this study was to determine the occurrence of non-ischemic cardiac injury using cardiac magnetic resonance (CMR) imaging in patients with persistent cardiac symptoms [...] Read more.
The prevalence and clinical consequences of coronavirus disease 2019 (COVID-19)-related non-ischemic cardiac injury are under investigation. The main purpose of this study was to determine the occurrence of non-ischemic cardiac injury using cardiac magnetic resonance (CMR) imaging in patients with persistent cardiac symptoms following recovery from COVID-19 pneumonia. We conducted a single-center, cross-sectional study. Between January 2021 and May 2021, we enrolled 121 patients with a recent COVID-19 infection and persistent cardiac symptoms. Study participants were divided into those who required hospitalization during the acute phase of SARS-CoV-2 infection (n = 58; 47.9%) and those non-hospitalized (n = 63; 52.1%). Non-ischemic cardiac injury (defined as the presence of late gadolinium enhancement (LGE) lesion and/or active myocarditis in CMR) was detected in over half of post-COVID-19 patients (n = 64; 52.9%). LGE lesions were present in 63 (52.1%) and active myocarditis in 10 (8.3%) post-COVID-19 study participants. The majority of LGE lesions were located in the left ventricle at inferior and inferolateral segments at the base. There were no significant differences in the occurrence of LGE lesions (35 (60.3%) vs. 28 (44.4%); p = 0.117) or active myocarditis (6 (10.3%) vs. 4 (6.3%); p = 0.517) between hospitalized and non-hospitalized post-COVID-19 patients. However, CMR imaging revealed lower right ventricular ejection fraction (RVEF; 49.5 (44; 54) vs. 53 (50; 58) %; p = 0.001) and more frequent presence of reduced RVEF (60.3% vs. 33.3%; p = 0.005) in the former subgroup. In conclusion, more than half of our patients presenting with cardiac symptoms after a recent recovery from COVID-19 pneumonia had CMR imaging abnormalities indicating non-ischemic cardiac injury. The most common finding was LGE, while active myocarditis was detected in the minority of patients. CMR imaging abnormalities were observed both in previously hospitalized and non-hospitalized post-COVID-19 patients. Further research is needed to determine the long-term cardiovascular consequences of COVID-19 infection and the optimal management of patients with suspected post-COVID-19 non-ischemic cardiac injury. Full article
(This article belongs to the Special Issue New Advances and Insights in Inflammatory Cardiomyopathy)
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Review

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23 pages, 1337 KiB  
Review
Myocarditis: Etiology, Pathogenesis, and Their Implications in Clinical Practice
by Emil Brociek, Agata Tymińska, Andrea Silvio Giordani, Alida Linda Patrizia Caforio, Romuald Wojnicz, Marcin Grabowski and Krzysztof Ozierański
Biology 2023, 12(6), 874; https://doi.org/10.3390/biology12060874 - 17 Jun 2023
Cited by 3 | Viewed by 4354
Abstract
Myocarditis is an inflammatory disease of the myocardium caused by infectious or non-infectious agents. It can lead to serious short-term and long-term sequalae, such as sudden cardiac death or dilated cardiomyopathy. Due to its heterogenous clinical presentation and disease course, challenging diagnosis and [...] Read more.
Myocarditis is an inflammatory disease of the myocardium caused by infectious or non-infectious agents. It can lead to serious short-term and long-term sequalae, such as sudden cardiac death or dilated cardiomyopathy. Due to its heterogenous clinical presentation and disease course, challenging diagnosis and limited evidence for prognostic stratification, myocarditis poses a great challenge to clinicians. As it stands, the pathogenesis and etiology of myocarditis is only partially understood. Moreover, the impact of certain clinical features on risk assessment, patient outcomes and treatment options is not entirely clear. Such data, however, are essential in order to personalize patient care and implement novel therapeutic strategies. In this review, we discuss the possible etiologies of myocarditis, outline the key processes governing its pathogenesis and summarize best available evidence regarding patient outcomes and state-of-the-art therapeutic approaches. Full article
(This article belongs to the Special Issue New Advances and Insights in Inflammatory Cardiomyopathy)
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13 pages, 577 KiB  
Review
Immunosuppressive Therapy of Biopsy-Proven, Virus-Negative, Autoimmune/Immune-Mediated Myocarditis—Focus on Azathioprine: A Review of Existing Evidence and Future Perspectives
by Justyna Grzechocińska, Agata Tymińska, Andrea Silvio Giordani, Julia Wysińska, Ewa Ostrowska, Anna Baritussio, Alida Linda Patrizia Caforio, Marcin Grabowski, Renzo Marcolongo and Krzysztof Ozierański
Biology 2023, 12(3), 356; https://doi.org/10.3390/biology12030356 - 24 Feb 2023
Cited by 2 | Viewed by 2175
Abstract
The use of immunosuppressive therapy (IT) in biopsy-proven, autoimmune/immune-mediated (AI), virus-negative myocarditis has become the standard of care. In particular, according to recent guidelines, azathioprine (AZA), in association with steroids, is a cornerstone of first-line therapy regimens. IT may have a crucial impact [...] Read more.
The use of immunosuppressive therapy (IT) in biopsy-proven, autoimmune/immune-mediated (AI), virus-negative myocarditis has become the standard of care. In particular, according to recent guidelines, azathioprine (AZA), in association with steroids, is a cornerstone of first-line therapy regimens. IT may have a crucial impact on the natural history of AI myocarditis, preventing its progression to end-stage heart failure, cardiovascular death, or heart transplantation, provided that strict appropriateness and safety criteria are observed. In particular, AZA treatment for AI virus-negative myocarditis requires the consideration of some crucial aspects regarding its pharmacokinetics and pharmacodynamics, as well as a high index of suspicion to detect its overt and/or subclinical side effects. Importantly, besides a tight teamwork with a clinical immunologist/immuno-rheumatologist, before starting IT, it is also necessary to carry out a careful “safety check-list” in order to rule out possible contraindications to IT and minimize patient’s risk. The aim of this review is to describe the pharmacological properties of AZA, as well as to discuss practical aspects of its clinical use, in the light of existing evidence, with particular regard to the new field of cardioimmunology. Full article
(This article belongs to the Special Issue New Advances and Insights in Inflammatory Cardiomyopathy)
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