Pankuweit S, Maisch B
Klinik für Innere Medizin - Kardiologie, Philipps-Universität Marburg, Baldingerstr., 35043, Marburg, Deutschland,
Herz. 2013 Dec;38(8):855-61. doi: 10.1007/s00059-013-3988-7.
Despite great advances in the pathophysiology and etiology of myocarditis, the clinical diagnosis of myocarditis in daily clinical practise remains challenging. Often the diagnosis was not clear because of the heterogeneity of clinical symptoms and the lack of guidelines for adequate diagnostic requirements and consecutive treatment options. The European Society of Cardiology (ESC) Working Group on Myocardial and Pericardial Diseases established a working group of experts to improve the diagnosis and management of myocarditis and to provide a common consensus statement as a reference for future registries and controlled trials. The goal was to bridge the gap between clinical- and tissue-based diagnosis by formulating a concept concerning essential diagnostics and treatment of these patients that would be accepted across Europe. Only in this manner is it possible to establish a basis for national and international registries and double-blind randomized treatment trials for the etiologically differentiated treatment of myocarditis, which appear promising due to numerous studies in recent years. In this paper, two members from the expert working group summarize the most important aspects of this position paper on the etiology, diagnosis, management, and treatment of myocarditis, which were published in the July 2013 issue of European Heart Joumal.
尽管心肌炎的病理生理学和病因学取得了巨大进展,但在日常临床实践中,心肌炎的临床诊断仍然具有挑战性。由于临床症状的异质性以及缺乏关于适当诊断要求和连续治疗方案的指南,诊断往往不明确。欧洲心脏病学会(ESC)心肌和心包疾病工作组成立了一个专家工作组,以改善心肌炎的诊断和管理,并提供一份共同的共识声明,作为未来登记和对照试验的参考。目标是通过制定一个关于这些患者基本诊断和治疗的概念来弥合基于临床和基于组织的诊断之间的差距,这个概念将在整个欧洲得到认可。只有通过这种方式,才有可能为心肌炎病因学差异化治疗的国家和国际登记以及双盲随机治疗试验奠定基础,近年来的大量研究表明这些试验前景广阔。在本文中,专家工作组的两名成员总结了这份关于心肌炎病因、诊断、管理和治疗的立场文件的最重要方面,该文件发表在2013年7月的《欧洲心脏杂志》上。