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Project

Improvement of risk stratification and treatment in acute myocarditis.

Acute myocarditis (AM) is an inflammatory disease of the heart that can be caused by infectious agents, autoimmune disorders, and drug hypersensitivity reactions. The diagnosis of AM is based on symptoms, biomarkers and non-invasive imaging. Cardiovascular magnetic resonance imaging (CRM) can accurately diagnose AM by detection of oedema and inflammation in the acute setting, as well as demonstration of residual scar after recovery. In virus-triggered AM, it is assumed that myocardial injury mainly results from autoimmunity. Although there is a rationale for immunosuppressive therapy, no trial has tested this hypothesis in the acute phase. The multicentre MYTHS trial will evaluate the efficacy of pulsed intravenous corticosteroids on top of standard therapy in patients with fulminant AM (left ventricular ejection fraction (LVEF) <41%). The first aim of this project proposal is to evaluate the treatment with corticosteroids in patients with complicated, non-fulminant AM (LVEF 41-50%) regarding outcome (cardiac death and life-threatening arrhythmias) and myocardial scar formation on CMR, as these patients have an increased risk of adverse events, but will not be included in the main MYTHS trial. Second, we want to improve risk stratification in patients with AM by identifying prognostic markers related to myocardial scar on baseline and follow-up CMR, to estimate sudden cardiac death risk and the need for a prophylactic implantable cardioverter-defibrillator.
Date:1 Jan 2022 →  Today
Keywords:INFLAMMATORY DISEASE, MRI IMAGING, MYOCARDIUM, TREATMENT
Disciplines:Autoimmunity, Cardiology, Diagnostic radiology
Project type:Collaboration project