Mason Jay W
Department of Internal Medicine, J527 Kentucky Clinic 0284, University of Kentucky, Lexington, KY 40506, USA.
Cardiovasc Res. 2003 Oct 15;60(1):5-10. doi: 10.1016/s0008-6363(03)00437-1.
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.
心肌炎是一种复杂的疾病，因为多种致病机制都在其中发挥作用。虽然这些机制似乎按时间顺序依次起作用，但在某些情况下它们无疑会相互重叠，这使得诊断和治疗变得困难。最终，可能会导致扩张型心肌病（DCM）。大量仍属间接的证据表明，病毒性心肌炎在DCM的病因中起主要作用。DCM患者心肌中普遍存在病毒遗传物质和病毒蛋白，这提供了最有说服力的证据，但因果关系的证据仍然不足。然而，由于近年来心力衰竭患病率显著上升，应开发抗病毒和抗炎疗法，以发挥其预防或改善DCM的潜力。
