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Cardiovascular Research 2003 60(1):5-10; doi:10.1016/S0008-6363(03)00437-1
© 2003 by European Society of Cardiology
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Copyright © 2003, European Society of Cardiology

Myocarditis and dilated cardiomyopathy

An inflammatory link

Jay W Mason*

Department of Internal Medicine, J527 Kentucky Clinic 0284, University of Kentucky, Lexington, KY 40506, USA

*Tel.: +1-859-257-5116; fax: +1-859-257-8364. Email address: jmason12{at}charter.net

Myocarditis is a complex disease because multiple pathogenetic mechanisms play a role. While these mechanisms appear to act in a chronological cascade, they undoubtedly overlap in some cases, rendering diagnosis and treatment difficult. Ultimately, dilated cardiomyopathy (DCM) may result. A multitude of still-circumstantial evidence points to a major role of viral myocarditis in the etiology of DCM. The common presence of viral genetic material and viral proteins in the myocardium of patients with DCM provides the most compelling evidence, but proof of causality is still lacking. Nevertheless, because of the striking increase in heart failure prevalence in recent years, anti-viral and anti-inflammatory therapies should be developed for their potential to prevent or ameliorate DCM.

KEYWORDS Myocarditis; Dilated cardiomyopathy; Autoimmunity; Heart failure; Immunosuppression

Time for primary review 21 days.


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