Modern strategy for the treatment of myocarditis in children
https://doi.org/10.21508/1027-4065-2022-67-1-28-38
Abstract
The article presents data on the current strategy for the treatment of myocarditis in children. The authors discuss the tactics of treatment of patients with unstable hemodynamics requiring emergency medical care using inotropic support. The possibilities of surgical methods of treatment of decompensated heart failure in myocarditis (artificial left ventricle, extracorporeal membrane oxygenation, heart transplantation) are clarified. Current approaches to the treatment of myocarditis with stable hemodynamics are described. Data on the effectiveness of angiotensin enzyme inhibitors and beta-blockers for the treatment of myocarditis in children are presented. Indications for immunosuppressive and immunomodulatory therapy are discussed
About the Author
L. V. LeontyevaRussian Federation
Moscow
References
1. Caforio A.L, Pankuweit S., Arbustini E., Basso C., Gimeno-Blanes J., Felix S.B. et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34(33): 2636–2648. DOI: 10.1093/eurheartj/eht210
2. Pankuweit S., Maisch B. Etiology, diagnosis, management, and treatment of myocarditis. Position paper from the ESC Working Group on Myocardial and Pericardial Diseases. Herz 2013; 38: 855–861. DOI: org/10.1007/s00059–013–3988–7
3. Tschöpe C., Ammirati E., Bozkurt B., Caforio A.L., Cooper L.T., Felix S.B. et al. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. Nat Rev Cardiol 2021; 18(3): 169–193. DOI: 10.1038/s41569–020–00435-x
4. Kantor P.F., Lougheed J., Dancea A., McGillion M., Barsbos N., Chan C. et al. Presentation, Diagnosis, and Medical Management of Heart Failure in Children: Canadian Cardiovascular Society Guidelines Can J Cardiol 2013; 29(12): 1535–1552. DOI: 10.1016/j.cjca.2013.08
5. Kirk R., Dipchand A.I., Rosenthal D.N., Addonizio L., Burch M., Chrisant M., Dubin A. The International Society for Heart and Lung Transplantation Guidelines for the management of pediatric heart failure: Executive summary J Heart Lung Transplant 2014; 33(9): 888–909. DOI: 10.1016/ j.healun.2014.06.002
6. Bejiq К., Retkoceri К., Maloku A., Mustafa A., Bejiqi H., Bejiqi R. The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature /Open Access Macedonian. J Med Scie 2019; 7(1): 162–173. DOI: 10.3889/oamjms.2019.010
7. Suominen P., Mattila N., Nyblom O., Rautiainen P., Turanlahti M., Rahkonen O. The Hemodynamic Effects and Safety of Repetitive Levosimendan Infusions on Children With Dilated Cardiomyopathy. World J Pediatr Congenit Heart Surg 2017; 8(1): 25–31. DOI: 10.1177/2150135116674466
8. Hetzer R., Potapov E.V., Stiller B., Weng Y., Hübler M., Lemmer J. et al. Improvement in survival after mechanical circulatory support with pneumatic pulsatile ventricular assist devices in pediatric patients. Ann Thorac Surg 2006; 82: 917–924. DOI: 10.1016/j.athoracsur.2006.03.065
9. Canter С., Simpson P. Diagnosis and Therapy for Myocarditis in Children in the Current Era. Circulation 2014; 129: 115– 128. DOI: 10.1161/Circulation AHA.113.001372
10. Almond C.S., Morales D.L., Blackstone E.H., Turrentine M.W., Imamura M., Massicotte M.P. et al. Berlin Heart EXCOR pediatric ventricular assist device for bridge to heart transplantation in US children. Circulation 2013; 127(16): 1702–1711. DOI: 10.1161/ Circulation AHA. 112. 000685d
11. Nahum E., Dagan O., Lev A., Shukrun G., Amir G., Frenkel G. et al. Favorable outcome of pediatric fulminant myocarditis supported by extracorporeal membranous oxygenation. Pediatric Cardiol 2010; 31(7): 1059–1063. DOI: 10.1007/s00246– 010–9765-y PMid:20734191
12. Rajagopal S.K., Almond C.S., Laussen P.C., Rycus P.T., Wypij D., Thiagarajan R.R. Extracorporeal membrane oxygenation for the support of infants, children, young adults with acute myocarditis: a review of the extracorporeal life support organization registry. Crit Care Med 2010; 38: 382–387. DOI: 10.1097/ CCM.0b013e3181bc8293 PMid:19789437
13. Wilmot I., Morales D.L., Price J.F., Rossano J.W., Kim J.J., Decker J.A. et. al. Effectiveness of mechanical circulatory support in children with acute fulminant and persistent myocarditis. J Card Fail 2011; 17: 487–494. DOI: 10.1016/j.cardfail.2011.02.008
14. Ahmad T., Jackson K., Rao V.S., Tang W.H.W., Brisco-Bacik M.A., Chen H.H. et al. Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury Circulation 2018; 137(19): 2016–2028. DOI: 10.1161/Circulation AHA.117.030112
15. Myocarditis. Clinical recommendations of Russian Cardiological Society. RRST 2020: 108 (in Russ.)
16. Cooper L.T., Elаmm C. Giant cell myocarditis: diagnosis and treatment. Herz 2012; 37: 632–636. DOI: 10.1007/s00059– 012–3658–1
17. Сallan P.D., Baltabaeva A., Kamal M., Wong J., Lane R., Robertus J.L. et al. Acute fulminant necrotizing eosinophilic myocarditis: early diagnosis and treatment ESC Heart Fail 2017; 4(4): 660–664 DOI: 10.1002/ehf2.12146
18. Priori S.G., BlomstrÛm-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J. et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: the Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the Europe. Eur Heart J 2015; 36: 2793–2867. DOI: 10.1093/eurheartj/ehv316
19. González -Torrecilla E., Arenal A., Atienza F., Datino T., Bravo L., Ruiz P. et al. Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies. Rev Recent Clin Trials 2015; 10(2): 111. DOI: 10.2174/1574887110666150407104312
20. Ageno W., Turpie A.G. Clinical trials of deep vein thrombosis prophylaxis in medical patients. Clin Cornerstone 2005; 7(4): 16–22. DOI: 10.1016/s1098–3597(05)80099–7
21. Godsel L.M., Leon J.S., Engman D.M. Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists in experimental myocarditis. Curr Pharm Des 2003; 9: 723– 735. DOI: 10.2174/1381612033455440
22. McNamara D.M., Starling R.C., Cooper L.T., Boehmer J.P., Mather P.J., Janosko K.M. et al. Investigators. Clinical and demographic predictors of outcomes in recent onset dilated cardiomyopathy: results of the IMAC (Intervention in Myocarditis and Acute Cardiomyopathy)-2 study. J Am Coll Cardiol 2011; 58(11): 1112–1118. DOI: 10.1016/j.jacc.2011.05.033
23. Seko Y. Effect of the angiotensin II receptor blocker olmesartan on the development of murine acute myocarditis caused by coxsackievirus B3. Clin Sci (Lond) 2006; 110(3): 379–386. DOI: 10.1042/CS20050299
24. Yuan Z., Shioji K., Kihara Y., Takenaka H., Onozawa Y., Kishimoto C. Cardioprotective effects of carvedilol on acute autoimmune myocarditis: anti-inflammatory effects associated with antioxidant property. Am J Physiol Heart Circ 2004; 286(1): H83–90. DOI: 10.1152/ajpheart.00536.2003
25. Xiao J., Shimada M., Liu W., Hu D., Matsumori A. Antiinflammatory effects of eplerenone on viral myocarditis. Eur J Heart Fail 2009; 11: 349–353. DOI: 10.1093/eurjhf/hfp023. Epub 2009 Feb 12
26. Matsumori A., Igata H., Ono K., Iwasaki A., Miyamoto T., Nishio R., Sasayama S. High doses of digitalis increase the myocardial production of proinflammatory cytokines and worsen myocardial injury in viral myocarditis: a possible mechanism of digitalis toxicity. Jpn Circ J 1999; 63: 934–940. DOI: 10.1253/jcj.63.934
27. Bonnet D., Berger F., Jokinen E., Kantor P.F., Daubeney P Ivabradine in children with dilated cardiomyopathy and symptomatic chronic heart failure. J Am Coll Cardiol 2017; 70: 1262–1272. DOI: 10.1016/j.jacc.2017.07.725
28. Pinninti S.G., Kimberlin D.W. Preventing herpes simplex virus in the newborn. Clin Perinatol 2014; 41(4): 945–955. DOI: 10.1016/j.clp.2014.08.012
29. Lim Y., Lyall H. Congenital cytomegalovirus — who, when, what–with and why to treat? J Infect 2017; 74(1): S89–S94. DOI: 10.1016/S0163–4453(17)30197–4
30. Dominguez F., Kühl U., Pieske B., Garcia-Pavia P., Tschöpe C. Myocarditis and Inflammatory Cardiomyopathy: Reemergence of Endomyocardial Biopsy Rev Esp Cardiol 2016; 69(2): 178–187. DOI: 0.1016/j.rec.2015.10.015
31. Maisch B., Pankuweit S. Current treatment options in (peri) myocarditis and inflammatory cardiomyopathy. Herz 2012; 37(6): 644–56. DOI: 10.1007/s00059–012–3679–9
32. Wojnicz R., Nowalany-Koziolaska E., Wojciechowska C., Glanowska G., Wilczewski P., Niklewski T. et al. Randomized, placebo-controlled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy. Two-year follow-up results. Circulation 2001; 104: 39–45 DOI: 10.1161/01.cir.104.1.39
33. Mason J.W., O’Connell J.B., Herskowitz A., Rose N.R., McManus B.M., Billingham M.E., Moon T.E. A clinical trial of immunosuppressive therapy for myocarditis. N Engl J Med 1995; 333: 269–275 DOI: 10.1056/NEJM199508033330501
34. Frustaci A., Russo M.A., Chimenti C. Randomized study on the efficacy of immunosuppressive therapy in patients with virus-negative inflammatorycardiomyopathy: the TITIMIC study. Eur Heart J 2009; 30(16): 1995–2002. DOI: 10.1093/ eurheartj/ehp249
35. Maisch B. Cardio-Immunology of Myocarditis: Focus on Immune Mechanisms and Treatment Options Front Cardiovasc Med 2019; 6: 48. DOI: 10.3389/fcvm.2019.00048
36. Camargo P.R., Okay T.S., Yamamoto L., Del Negro G.M., Lopes A.A. Myocarditis in children and detection of viruses in myocardial tissue: implications for immunosuppressive therapy. Int J Cardiol 2011; 148(2): 204–208. DOI: 10.1016/ j.ijcard.2009
37. Hia C.P., Yip W.C., Tai B.C., Queket S.C. Immunosuppressive therapy in acute myocarditis: an 18-year systematic review. Arch Dis Child 2004; 89: 580–584. DOI: 10.1136/ adc.2003.034686
38. Burch M. Immune suppressive treatment in pediatric myocarditis: still awaiting the evidence Heart 2004; 90: 1103–1104. DOI: 10.1136/hrt.2004.034082
39. Baandrup U. Eosinophilic myocarditis. Herz 2012; 37: 849– 852. DOI: 10.1007/s00059–012–3701–2
40. McNamara D.M., Holubkov R., Starling R.C., Dec G.W., Loh E., Torre-Amione G. et al. Controlled trial of intravenous immune globulin in recent-onset dilated cardiomyopathy. Circulation 2001; 103: 2254–2259. DOI: 10.1161/01. cir.103.18.2254
41. Maisch B.P., Alter P. Treatment options in myocarditis and inflammatory cardiomyopathy Focus on i. v. immunoglobulins Herz 2018; 43: 423–430 DOI: 10.1007/s00059–018–4719
42. Dennert R., Velthuis S., Schalla S., Eurlings L., van Suylen R.J., van Paassen P. et al. Intravenous immunoglobulin therapy for patients with idiopathic cardiomyopathy and endomyocardial biopsy-proven high PVB19 viral load. Antivir Ther 2010; 15(2): 193–201. DOI: 10.3851/IMP1516
43. Huang X., Sun Y., Su G., Li Y., Shuai X. Intravenous Immunoglobulin Therapy for Acute Myocarditis in Children and Adults Int Heart J 2019; 60(2): 359–365. DOI: 10.1536/ihj.18–299
44. Teele S.A., Allan C.K., Laussen P.C., Newburger J.W., Gauvreau K., Thiagarajan R.R. Management and outcomes in pediatric patients presenting with acute fulminant myocarditis. J Pediatr 2011; 158(4): 638–643. DOI: 10.1016/j. jpeds.2010.10.015
45. González-Torrecilla E., Arenal A., Atienza F., Datino T., Bravo L., Ruiz P. et al. Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies. Rev Recent Clin Trials 2015; 10(2): 111. DOI: 10.2174/1574887110666150407104312
46. Halliday B.P., Cleland J.G., Goldberger J.J., Prasad S.K. Personalizing Risk Stratification for Sudden Death in Dilated Cardiomyopathy: The Past, Present, and Future. Circulation 2017; 136(2): 215–231. DOI: 10.1161/CIRCULATIONAHA.116.027
47. Kandolin R., Lehtonen J., Salmenkivi K., Räisänen-Sokolowski A., Lommi J., Kupari M. Diagnosis, treatment, and outcome of giant-cell myocarditis in the era of combined immunosuppression. Circ Heart Fail 2012; 6(1): 15–22. DOI: 10.1161/CIRC HEART FAILURE.112.969261
48. Pietra B.A., Kantor P.F., Bartlett H.L., Chin C., Canter C.E., Larsen R.L. et al. Early predictors of survival to and after heart transplantation in children with dilated cardiomyopathy. Circulation 2012; 126: 1079–1086. DOI: 10.1161/CIRCULATIONAHA.110.011999
49. US National Library of Medicine. ClinicalTrials.gov https:// clinicaltrials.gov/ct2/show/NCT03018834. Ссылка активна на 17.12.2021.
Review
For citations:
Leontyeva L.V. Modern strategy for the treatment of myocarditis in children. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2022;67(1):28-38. (In Russ.) https://doi.org/10.21508/1027-4065-2022-67-1-28-38