Myocarditis Cardiomyopathy: Selected Problems Of Pathogenesis And Clinic (international Boehringer Mannheim Symposia)

Primary myocardial disease, nowadays referred to as congestive or, more re­ cently, dilating cardiomyopathy, comprises disorders of varied etiology. Most oftenly the pathogenetic mechanism or causative agent remains unknown. The significance of inflammatory processes, i.e. myocarditis in a wider sense as the etiologic factor has been debated for many years. In a few instances, especially in children and newborns viral infections can be incriminated. In adults this etiology can be ascertained only in rare instances. And it has remained entirely uncertain if, or under which circumstances, and how often virus myocarditis can lead to a chronic disorder of the heart, namely dilated cardiomyopathy. Although it would seem conceivable that an immunological response to an infectious agent might induce parenchymal damage with subsequent loss of cellular function and structural integrity of permanent nature, i.e. dilatation, functional deterioration and dysrhythmias, numerous attempts to establish such a pathogenetic mechanism have not yet furnished convinicing results. Therefore the reader will direct his attention specifically to the respective contribution in this volume. Morphologic studies have yielded a host of new and intriguing findings in cardiomyopathy, but have likewise failed to settle the basic question as to which etiology can be held responsible in a given case, especially if an inflam­ matory process can be incriminated. Specific processes such as sarcoidosis of the heart undoubtedly furnish examples of chronic inflammation as a cause of dilating cardiomyopathy. This disorder, however, as a specific inflammato­ ry myocardial affection, i.e. myocarditis, is encountered only infrequently. Front Matter....Pages I-XV Myocarditis — Cardiomyopathy Historic Survey and Definition....Pages 1-5 Myocarditis as a Possible Cause of Cardiomyopathy....Pages 7-11 The Natural History of Dilated Cardiomyopathy and the Problem of Myocarditis....Pages 13-23 Myocarditis and Cardiomyopathy: The Panoramic Nature of Their Etiology, Pathogenesis, and Clinical Consequences, with Special Consideration of the Involvement of the Conduction System....Pages 25-62 Immunologic Findings in Myocardial Diseases, with Particular Reference to Myocarditis....Pages 63-70 Diagnostic and Pathogenic Relevance of Antimyocardial Antibodies and Circulating Immune Complexes in Perimyocarditis and Congestive Cardiomyopathy....Pages 71-79 Right Ventricular Dysplasia: A Report of 24 Adult Cases....Pages 81-93 Eosinophilic Heart Disease....Pages 95-100 Echocardiographic Findings in Patients with Hypereosinophilia....Pages 101-107 Biochemical Findings in Serum of Patients with Congestive Cardiomyopathy: Is Serum Selenium Concentration a Possible Marker?....Pages 109-116 The Clinical Significance of Myocardial Biopsy....Pages 117-133 Myocardial Hypertrophy — Development and Regression....Pages 135-142 Morphometric and Cytophotometric Investigations of Myocardial Diseases....Pages 143-174 Left Ventricular Muscle Mass and Chamber Volume in Dilative Cardiomyopathy — an Angiocardiographic Study....Pages 175-181 Left Ventricular Mass and Wall Stress in the Evaluation of Myocardial Performance: Functional, Metabolic, and Therapeutic Consequences in Chronic Heart Disease....Pages 183-195 Congestive Cardiomyopathy: Pathophysiological Aspects....Pages 197-204 Computertomographic Findings in Congestive Cardiomyopathy....Pages 205-211 Echocardiographic Studies in Cardiomyopathies....Pages 213-223 Central Hemodynamics at Rest and During Exercise in Dilative Cardiomyopathy....Pages 225-232 Involvement of the Sinus Node and the Conduction System in Myocarditis and Cardiomyopathy....Pages 233-243 Prevalence of Arrhythmias During 24-Hour Electrocardiographic Monitoring in Patients with Dilative Cardiomyopathy....Pages 245-254 Arrhythmias in Patients with Congestive and Hypertrophic Cardiomyopathy During Holter Monitoring and Interventions....Pages 255-261 Repetitive Response to Ventricular Extrastimuli in Patients with Dilated Cardiomyopathy....Pages 263-267 ST-T Wave Changes in Myocarditis and Cardiomyopathy....Pages 269-281 Alterations of Ventricular Depolarization in Myocarditis and Cardiomyopathy....Pages 283-294 Interaction Between Digoxin and Antiarrhythmic, Diuretic, or Vasodilator Drugs....Pages 295-303 Evaluation of Long-term Efficacy of Digoxin Therapy in Congestive Cardiomyopathy....Pages 305-308 Artificial Ventilation in Cardiac Failure....Pages 309-311 Back Matter....Pages 313-318