Myocarditis—Personalized Medicine by Expanded Endomyocardial Biopsy Diagnostics

Abstract

Myocarditis and dilated cardiomyopathy (DCM) are acute or chronic disorders of myocardium. The gold standard for final confirmation of causative reasons of these heart muscle diseases is the endomyocardial biopsy (EMB) analysis. Due to focal pathology, diagnostics are failing if the EMB does not contain the area of interest. Personalized medicine comprises the genetic information together with the phenotypic and environmental factors to yield a tailored healthcare for each individual and removes the limitations of the “one-size-fits-all” therapy approach. This provides the opportunity to translate therapies from bench to bedside, to diagnose and predict disease, and to improve patient-tailored treatments based on the unique signatures of a patient’s disease. Furthermore, novel treatment schedules can be identified which have eventually the chance to enhance long-term survivals. Global biomarkers such as specific gene expression signatures or miRNA profiles not only have the potential to reduce this problem but also add valuable information for individualized therapy decisions. In future, multiplex approaches allowing rapid and absolutely reliable identification of inflammatory or virally-induced myocardial diseases will replace singleplex methods such as direct detection of viral genomes in one single biopsy. Gene or miRNA profiles are upcoming diagnostic biomarkers for cardiomyopathies which are not only detectable in tissue samples but in body fluids as well. Consequently, a systemic diagnostic approach by determination of distinct expression pattern in e.g., peripheral blood samples will support the characterization of distinct cardiomyopathies by means of non-invasive methods.

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Lassner, D. , Rohde, M. , Siegismund, C. , Kühl, U. , Gross, U. , Escher, F. , Tschöpe, C. and Schultheiss, H. (2014) Myocarditis—Personalized Medicine by Expanded Endomyocardial Biopsy Diagnostics. World Journal of Cardiovascular Diseases, 4, 325-340. doi: 10.4236/wjcd.2014.46042.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Schultheiss, H.-P., Kühl, U. and Cooper, L.T. (2011) The Management of Myocarditis. European Heart Journal, 32, 2616-2625.
http://dx.doi.org/10.1093/eurheartj/ehr165
[2] Caforio, A.L.P., Pankuweit, S., Arbustini, E., Basso, C., Gimeno-Blanes, J., Felix, S.B. and Elliott, P.M. (2013) 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. European Heart Journal, 34, 2636-2648.
http://dx.doi.org/10.1093/eurheartj/eht210
[3] Cooper, L.T., Baughman, K.L., Feldman, A.M., Frustaci, A., Jessup, M., Kuhl, U. and Virmani, R. (2007) The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Circulation, 116, 2216-2233.
http://dx.doi.org/10.1161/CIRCULATIONAHA.107.186093
[4] Liu, P.P. and Schultheiss, H.P. (2008) Myocarditis. In: Baunwald, Ed., Heart Disease, W B Saunders Co., Philadelphia, 1775-1792.
[5] Cooper, L.T. (2005) The Natural History and Role of Immunoadsorption in Dilated Cardiomyopathy. Journal of Clinical Apheresis, 20, 256-260.
http://dx.doi.org/10.1002/jca.20045
[6] Meder, B., Rühle, F., Weis, T., Homuth, G., Keller, A., Franke, J. and Katus, H.A. (2013) A Genome-Wide Association Study Identifies 6p21 as Novel Risk Locus for Dilated Cardiomyopathy. European Heart Journal, 35, 1069-1077.
http://dx.doi.org/10.1093/eurheartj/eht251
[7] Schierding, W., Cutfield, W.S., and O’Sullivan, J.M. (2014) The Missing Story Behind Genome Wide Association Studies: Single Nucleotide Polymorphisms in Gene Deserts Have a Story to Tell. Frontiers in Genetics, 5, 39.
http://dx.doi.org/10.3389/fgene.2014.00039
[8] Mestroni, L., Merlo, M., Taylor, M.R.G., Camerini, F. and Sinagra, G. (2011) Heart Failure and Personalized Medicine. Journal of Cardiovascular Medicine (Hagerstown, Md.), 12, 6-12. http://dx.doi.org/10.2459/JCM.0b013e32833e8b0d
[9] Blauwet, L.A. and Cooper, L.T. (n.d.) Myocarditis. Progress in Cardiovascular Diseases, 52, 274-288.
http://dx.doi.org/10.1016/j.pcad.2009.11.006
[10] Cooper, L.T., Berry, G.J. and Shabetai, R. (1997) Idiopathic Giant-Cell Myocarditis—Natural History and Treatment. Multicenter Giant Cell Myocarditis Study Group Investigators. The New England Journal of Medicine, 336, 1860-1866.
http://dx.doi.org/10.1056/NEJM199706263362603
[11] Taliercio, C.P., Olney, B.A. and Lie, J.T. (1985) Myocarditis Related to Drug Hypersensitivity. Mayo Clinic Proceedings, 60, 463-468.
http://dx.doi.org/10.1016/S0025-6196(12)60870-2
[12] Magnani, J.W. and Dec, G.W. (2006) Myocarditis: Current Trends in Diagnosis and Treatment. Circulation, 113, 876-890.
http://dx.doi.org/10.1161/CIRCULATIONAHA.105.584532
[13] Cooper, L.T., Baughman, K.L., Feldman, A.M., Frustaci, A., Jessup, M., Kuhl, U. and Virmani, R. (2007) The Role of Endomyocardial Biopsy in the Management of Cardiovascular Disease: A Scientific Statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. European Heart Journal, 28, 3076-3093.
http://dx.doi.org/10.1093/eurheartj/ehm456
[14] Dec, G.W., Palacios, I.F., Fallon, J.T., Aretz, H.T., Mills, J., Lee, D.C., and Johnson, R.A. (1985) Active Myocarditis in the Spectrum of Acute Dilated Cardiomyopathies. Clinical Features, Histologic Correlates, and Clinical Outcome. The New England Journal of Medicine, 312, 885-890.
http://dx.doi.org/10.1056/NEJM198504043121404
[15] Kühl, U., Pauschinger, M., Noutsias, M., Seeberg, B., Bock, T., Lassner, D. and Schultheiss, H.-P. (2005) High Prevalence of Viral Genomes and Multiple Viral Infections in the Myocardium of Adults with “Idiopathic” Left Ventricular Dysfunction. Circulation, 111, 887-893.
http://dx.doi.org/10.1161/01.CIR.0000155616.07901.35
[16] Felker, G.M., Boehmer, J.P., Hruban, R.H., Hutchins, G.M., Kasper, E.K., Baughman, K.L. and Hare, J.M. (2000) Echocardiographic Findings in Fulminant and Acute Myocarditis. Journal of the American College of Cardiology, 36, 227-232.
http://dx.doi.org/10.1016/S0735-1097(00)00690-2
[17] Pauschinger, M., Bowles, N.E., Fuentes-Garcia, F.J., Pham, V., Kühl, U., Schwimmbeck, P.L. and Towbin, J.A. (1999) Detection of Adenoviral Genome in the Myocardium of Adult Patients with Idiopathic Left Ventricular Dysfunction. Circulation, 99, 1348-1354.
http://dx.doi.org/10.1161/01.CIR.99.10.1348
[18] Breinholt, J.P., Moulik, M., Dreyer, W.J., Denfield, S.W., Kim, J.J., Jefferies, J.L. and Towbin, J.A. (2010) Viral Epidemiologic Shift in Inflammatory Heart Disease: The Increasing Involvement of parvovirus B19 in the Myocardium of Pediatric Cardiac Transplant Patients. The Journal of Heart and Lung Transplantation: The Official Publication of the International Society for Heart Transplantation, 29, 739-746.
http://dx.doi.org/10.1016/j.healun.2010.03.003
[19] Elliott, P., Andersson, B., Arbustini, E., Bilinska, Z., Cecchi, F., Charron, P. and Keren, A. (2008) Classification of the Cardiomyopathies: A Position Statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. European Heart Journal, 29, 270-276.
http://dx.doi.org/10.1093/eurheartj/ehm342
[20] Kühl, U., Pauschinger, M., Seeberg, B., Lassner, D., Noutsias, M., Poller, W. and Schultheiss, H.P. (2005) Viral Persistence in the Myocardium Is Associated with Progressive Cardiac Dysfunction. Circulation, 112, 1965-1970.
http://dx.doi.org/10.1161/CIRCULATIONAHA.105.548156
[21] Kawai, C. (1999) From Myocarditis to Cardiomyopathy: Mechanisms of Inflammation and Cell Death: Learning from the Past for the Future. Circulation, 99, 1091-1100.
http://dx.doi.org/10.1161/01.CIR.99.8.1091
[22] D’Ambrosio, A., Patti, G., Manzoli, A., Sinagra, G., Di Lenarda, A., Silvestri, F. and Di Sciascio, G. (2001) The Fate of Acute Myocarditis between Spontaneous Improvement and Evolution to Dilated Cardiomyopathy: A Review. Heart (British Cardiac Society), 85, 499-504.
http://dx.doi.org/10.1136/heart.85.5.499
[23] Figulla, H.R. (2004) Transformation of Myocarditis and Inflammatory Cardiomyopathy to Idiopathic Dilated Cardiomyopathy: Facts and Fiction. Medical Microbiology and Immunology, 193, 61-64.
http://dx.doi.org/10.1007/s00430-003-0205-y
[24] Kühl, U. and Schultheiss, H.P. (2010) Myocarditis in Children. Heart Failure Clinics, 6, 483-496.
http://dx.doi.org/10.1016/j.hfc.2010.05.009
[25] Bowles, N.E., Ni, J., Kearney, D.L., Pauschinger, M., Schultheiss, H.P., McCarthy, R. and Towbin, J.A. (2003) Detection of Viruses in Myocardial Tissues by Polymerase Chain Reaction. Evidence of Adenovirus as a Common Cause of Myocarditis in Children and Adults. Journal of the American College of Cardiology, 42, 466-472.
http://dx.doi.org/10.1016/S0735-1097(03)00648-X
[26] Lassner, D., Siegismund, C.S., Stehr, J., Rohde, M., Escher, F., Tschöpe, C. and Schultheiss, H.P. (2013) Recent Advances in Molecular Diagnostics and Treatment of Heart Muscle Diseases. Journal of Analytical Sciences, Methods and Instrumentation, 3, 98-109.
http://dx.doi.org/10.4236/jasmi.2013.32012
[27] Chimenti, C. and Frustaci, A. (2013) Contribution and Risks of Left Ventricular Endomyocardial Biopsy in Patients with Cardiomyopathies: A Retrospective Study over a 28-Year Period. Circulation, 128, 1531-1541.
http://dx.doi.org/10.1161/CIRCULATIONAHA.13.001414
[28] Lassner, D., Krueger, G.R.F., Buja, L.M. and Kuehl, U. (2014) HHV-6 and HHV-7 in Cardiovascular Diseases and Cardiomyopathies. In: Flammand, L., Lautenschlager, I., Krueger, G.R.F. and Ablashi, D.V., Eds., Human Herpesviruses HHV-6A, HHV-6B, and HHV-7: Diagnosis and Clinical Management, 3rd Edition, Elsevier B.V., Amsterdam, 267-280.
[29] Kühl, U., Lassner, D., Pauschinger, M., Gross, U.M., Seeberg, B., Noutsias, M. and Schultheiss, H.P. (2008) Prevalence of Erythrovirus Genotypes in the Myocardium of Patients with Dilated Cardiomyopathy. Journal of Medical Virology, 80, 1243-1251.
http://dx.doi.org/10.1002/jmv.21187
[30] Towbin, J.A., Ware, S.M. and Jefferies, J.L. (2010) Heart Transplants in Pediatric Patients: Viral Infection as a Loss Predictor. Future Cardiology, 6, 735-741.
http://dx.doi.org/10.2217/fca.10.105
[31] Kandolf, R. (2004) Virus Etiology of Inflammatory Cardiomyopathy. Deutsche Medizinische Wochenschrift (1946), 129, 2187-2192.
http://dx.doi.org/10.1055/s-2004-831863
[32] Norja, P., Hokynar, K., Aaltonen, L.M., Chen, R., Ranki, A., Partio, E.K. and Hedman, K. (2006) Bioportfolio: Lifelong Persistence of Variant and Prototypic Erythrovirus DNA Genomes in Human Tissue. Proceedings of the National Academy of Sciences of the United States of America, 103, 7450-7453.
http://dx.doi.org/10.1073/pnas.0602259103
[33] Pellett, P.E., Ablashi, D.V., Ambros, P.F., Agut, H., Caserta, M.T., Descamps, V. and Razonable, R.R. (2012) Chromosomally Integrated Human Herpesvirus 6: Questions and Answers. Reviews in Medical Virology, 22, 144-155.
http://dx.doi.org/10.1002/rmv.715
[34] Bültmann, B.D., Klingel, K., Sotlar, K., Bock, C.T., Baba, H.A., Sauter, M. and Kandolf, R. (2003) Fatal Parvovirus B19-Associated Myocarditis Clinically Mimicking Ischemic Heart Disease: An Endothelial Cell-Mediated Disease. Human Pathology, 34, 92-95.
http://dx.doi.org/10.1053/hupa.2003.48
[35] Bock, C.T., Klingel, K., Aberle, S., Duechting, A., Lupescu, A., Lang, F. and Kandolf, R. (2005) Human Parvovirus B19: A New Emerging Pathogen of Inflammatory Cardiomyopathy. Journal of Veterinary Medicine. B, Infectious Diseases and Veterinary Public Health, 52, 340-343.
[36] Klingel, K., Sauter, M., Bock, C.T., Szalay, G., Schnorr, J.J. and Kandolf, R. (2004) Molecular Pathology of Inflammatory Cardiomyopathy. Medical Microbiology and Immunology, 193, 101-107.
http://dx.doi.org/10.1007/s00430-003-0190-1
[37] Kuhl, U., Lassner, D., Dorner, A., Rohde, M., Escher, F., Seeberg, B. and Poller, W. (2013) A Distinct Subgroup of Cardiomyopathy Patients Characterized by Transcriptionally Active Cardiotropic Erythrovirus and Altered Cardiac Gene Expression. Basic Research in Cardiology, 108, 372.
http://dx.doi.org/10.1007/s00395-013-0372-y
[38] Di Luca, D., Mirandola, P., Ravaioli, T., Bigoni, B. and Cassai, E. (1996) Distribution of HHV-6 Variants in Human Tissues. Infectious Agents and Disease, 5, 203-214.
[39] Caruso, A., Rotola, A., Comar, M., Favilli, F., Galvan, M., Tosetti, M. and Di Luca, D. (2002) HHV-6 Infects Human Aortic and Heart Microvascular Endothelial Cells, Increasing Their Ability to Secrete Proinflammatory Chemokines. Journal of Medical Virology, 67, 528-533.
http://dx.doi.org/10.1002/jmv.10133
[40] Krueger, G.R.F., Rojo, J., Buja, L.M., Lassner, D. and Kuehl, U. (2008) Human Herpesvirus-6 ( HHV-6 ) Is a Possible Cardiac Pathogen: An Immunopathological and Ultrastructural Study. Hospital General, 71, 187-191.
[41] Arbuckle, J.H., Medveczky, M.M., Luka, J., Hadley, S.H., Luegmayr, A., Ablashi, D., Lund, T.C., Tolar, J., De Meirleir, K., Montoya, J.G., Komaroff, A.L., Ambros, P.F. and Medveczky, P.G. (2010) The Latent Human Herpesvirus-6A Genome Specifically Integrates in Telomeres of Human Chromosomes in Vivo and in Vitro. Proceedings of the National Academy of Sciences of the United States of America, 107, 5563-5568.
http://dx.doi.org/10.1073/pnas.0913586107
[42] Caforio, A.L.P., Calabrese, F., Angelini, A., Tona, F., Vinci, A., Bottaro, S., Ramondo, A., Carturan, E., Iliceto, S., Thiene, G. and Daliento, L. (2007) A Prospective Study of Biopsy-Proven Myocarditis: Prognostic Relevance of Clinical and Aetiopathogenetic Features at Diagnosis. European Heart Journal, 28, 1326-1333.
http://dx.doi.org/10.1093/eurheartj/ehm076
[43] Baboonian, C. and Treasure, T. (1997) Meta-Analysis of the Association of Enteroviruses with Human Heart Disease. Heart (British Cardiac Society), 78, 539-543.
[44] Holzmann, M., Nicko, A., Kühl, U., Noutsias, M., Poller, W., Hoffmann, W. and Pauschinger, M. (2008) Complication Rate of Right Ventricular Endomyocardial Biopsy via the Femoral Approach: A Retrospective and Prospective Study Analyzing 3048 Diagnostic Procedures over an 11-Year Period. Circulation, 118, 1722-1728.
http://dx.doi.org/10.1161/CIRCULATIONAHA.107.743427
[45] McCarthy, R.E., Boehmer, J.P., Hruban, R.H., Hutchins, G.M., Kasper, E.K., Hare, J.M. and Baughman, K.L. (2000) Long-Term Outcome of Fulminant Myocarditis as Compared with Acute (Nonfulminant) Myocarditis. The New England Journal of Medicine, 342, 690-695.
http://dx.doi.org/10.1056/NEJM200003093421003
[46] Why, H.J., Meany, B.T., Richardson, P.J., Olsen, E.G., Bowles, N.E., Cunningham, L., Freeke, C.A. and Archard, L.C. (1994) Clinical and Prognostic Significance of Detection of Enteroviral RNA in the Myocardium of Patients with Myocarditis or Dilated Cardiomyopathy. Circulation, 89, 2582-2589.
http://dx.doi.org/10.1161/01.CIR.89.6.2582
[47] Mason, J.W., O’Connell, J.B., Herskowitz, A., Rose, N.R., McManus, B.M., Billingham, M.E. and Moon, T.E. (1995) A Clinical Trial of Immunosuppressive Therapy for Myocarditis. The Myocarditis Treatment Trial Investigators. The New England Journal of Medicine, 333, 269-275.
http://dx.doi.org/10.1056/NEJM199508033330501
[48] Magnani, J.W., Danik, H.J.S., Dec, G.W. and DiSalvo, T.G. (2006) Survival in Biopsy-Proven Myocarditis: A Long-Term Retrospective Analysis of the Histopathologic, Clinical, and Hemodynamic Predictors. American Heart Journal, 151, 463-470.
http://dx.doi.org/10.1016/j.ahj.2005.03.037
[49] Frustaci, A., Chimenti, C., Calabrese, F., Pieroni, M., Thiene, G. and Maseri, A. (2003) Immunosuppressive Therapy for Active Lymphocytic Myocarditis: Virological and Immunologic Profile of Responders versus Nonresponders. Circulation, 107, 857-863.
http://dx.doi.org/10.1161/01.CIR.0000048147.15962.31
[50] Caforio, A.L., Goldman, J.H., Haven, A.J., Baig, K.M., Libera, L.D. and McKenna, W.J. (1997) Circulating Cardiac-Specific Autoantibodies as Markers of Autoimmunity in Clinical and Biopsy-Proven Myocarditis. The Myocarditis Treatment Trial Investigators. European heart journal, 18, 270-275.
[51] Bock, C.T., Klingel, K. and Kandolf, R. (2010) Human Parvovirus B19-Associated Myocarditis. The New England Journal of Medicine, 362, 1248-1249.
http://dx.doi.org/10.1056/NEJMc0911362
[52] Schmidt-Lucke, C., Spillmann, F., Bock, T., Kühl, U., Van Linthout, S., Schultheiss, H.P. and Tschöpe, C. (2010) Interferon Beta Modulates Endothelial Damage in Patients with Cardiac Persistence of Human Parvovirus b19 Infection. The Journal of Infectious Diseases, 201, 936-945.
http://dx.doi.org/10.1086/650700
[53] Jahns, R., Boivin, V., Schwarzbach, V., Ertl, G. and Lohse, M.J. (2008) Pathological Autoantibodies in Cardiomyopathy. Autoimmunity, 41, 454-461.
http://dx.doi.org/10.1080/08916930802031603
[54] Schulze, K., Becker, B.F., Schauer, R. and Schultheiss, H.P. (1990) Antibodies to ADP-ATP Carrier—An Autoantigen in Myocarditis and Dilated Cardiomyopathy--Impair Cardiac Function. Circulation, 81, 959-969.
http://dx.doi.org/10.1161/01.CIR.81.3.959
[55] Lurz, P., Eitel, I., Adam, J., Steiner, J., Grothoff, M., Desch, S. and Thiele, H. (2012) Diagnostic Performance of CMR Imaging Compared with EMB in Patients with Suspected Myocarditis. JACC: Cardiovascular Imaging, 5, 513-524.
http://dx.doi.org/10.1016/j.jcmg.2011.11.022
[56] Escher, F., Kasner, M., Kühl, U., Heymer, J., Wilkenshoff, U., Tschöpe, C. and Schultheiss, H.P. (2013) New Echocardiographic Findings Correlate with Intramyocardial Inflammation in Endomyocardial Biopsies of Patients with Acute Myocarditis and Inflammatory Cardiomyopathy. Mediators of Inflammation, 2013, Article ID: 875420.
http://dx.doi.org/10.1155/2013/875420
[57] Kasner, M., Sinning, D., Escher, F., Lassner, D., Kühl, U., Schultheiss, H.P. and Tschöpe, C. (2013) The Utility of Speckle Tracking Imaging in the Diagnostic of Acute Myocarditis, as Proven by Endomyocardial Biopsy. International Journal of Cardiology, 168, 3023-3024.
http://dx.doi.org/10.1016/j.ijcard.2013.04.016
[58] Frustaci, A., Russo, M.A. and Chimenti, C. (2009) Randomized Study on the Efficacy of Immunosuppressive Therapy in Patients with Virus-Negative Inflammatory Cardiomyopathy: The TIMIC Study. European Heart Journal, 30, 1995-2002.
http://dx.doi.org/10.1093/eurheartj/ehp249
[59] Lassner, D., Rohde, M., Gross, U.M., Escher, F., Schultheiss, H.P., Linke, R.P. and Kühl, U. (2011) Classification of Four Chemically Different Amyloid Types in Routine Endomyocardial Biopsies by Advanced Immunohistochemistry. Amyloid: The International Journal of Experimental and Clinical Investigation: The Official Journal of the International Society of Amyloidosis, 18, 76-78.
http://dx.doi.org/10.3109/13506129.2011.574354027
[60] Thomas Aretz, H. (1987) Myocarditis: The Dallas Criteria. Human Pathology, 18, 619-624.
http://dx.doi.org/10.1016/S0046-8177(87)80363-5
[61] Noutsias, M., Pauschinger, M., Ostermann, K., Escher, F., Blohm, J.H., Schultheiss, H. and Kühl, U. (2002) Digital Image Analysis System for the Quantification of Infiltrates and Cell Adhesion Molecules in Inflammatory Cardiomyopathy. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 8, MT59-MT71.
[62] Silverio, J.C., de-Oliveira-Pinto, L.M., da Silva, A.A., de Oliveira, G.M. and Lannes-Vieira, J. (2010) Perforin-Expressing Cytotoxic Cells Contribute to Chronic Cardiomyopathy in Trypanosoma cruzi Infection. International Journal of Experimental Pathology, 91, 72-86.
http://dx.doi.org/10.1111/j.1365-2613.2009.00670.x
[63] Kittleson, M.M. and Hare, J.M. (2005) Molecular Signature Analysis: The Potential of Gene-Expression Analysis in Cardiomyopathy. Future Cardiology, 1, 793-808.
http://dx.doi.org/10.2217/14796678.1.6.793
[64] Kühl, U., Lassner, D., von Schlippenbach, J., Poller, W. and Schultheiss, H.P. (2012) Interferon-Beta Improves Survival in Enterovirus-Associated Cardiomyopathy. Journal of the American College of Cardiology, 60, 1295-1296. http://dx.doi.org/10.1016/j.jacc.2012.06.026
[65] Kühl, U., Pauschinger, M., Schwimmbeck, P.L., Seeberg, B., Lober, C., Noutsias, M. and Schultheiss, H.P. (2003) Interferon-Beta Treatment Eliminates Cardiotropic Viruses and Improves Left Ventricular Function in Patients with Myocardial Persistence of Viral Genomes and Left Ventricular Dysfunction. Circulation, 107, 2793-2798.
http://dx.doi.org/10.1161/01.CIR.0000072766.67150.51
[66] Kühl, U., Rohde, M., Lassner, D., Gross, U.M., Escher, F. and Schultheiss, H.P. (2012) miRNA as Activity Markers in Parvo B19 Associated Heart Disease. Herz, 37, 637-643.
http://dx.doi.org/10.1007/s00059-012-3656-3
[67] Hershberger, R.E., Lindenfeld, J., Mestroni, L., Seidman, C.E., Taylor, M.R.G. and Towbin, J.A. (2009) Genetic Evaluation of Cardiomyopathy—A Heart Failure Society of America Practice Guideline. Journal of Cardiac Failure, 15, 83-97.
http://dx.doi.org/10.1016/j.cardfail.2009.01.006
[68] Andreasen, C., Nielsen, J.B., Refsgaard, L., Holst, A.G., Christensen, A.H., Andreasen, L. and Olesen, M.S. (2013) New Population-Based Exome Data Are Questioning the Pathogenicity of Previously Cardiomyopathy-Associated Genetic Variants. European Journal of Human Genetics: EJHG, 21, 918-928.
http://dx.doi.org/10.1038/ejhg.2012.283
[69] Schultheiss, H.P. (2013) Genetic Testing Is Superior to Biopsy of the Myocardium in Cardiomyopathy—No. Deutsche Medizinische Wochenschrift (1946), 138, 599.
[70] Hütter, G., Nowak, D., Mossner, M., Ganepola, S., Müssig, A., Allers, K. and Thiel, E. (2009) Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation. The New England Journal of Medicine, 360, 692-698.
http://dx.doi.org/10.1056/NEJMoa0802905
[71] Muntinghe, F.L.H., Gross, S., Bakker, S.J.L., Landman, G.W.D., van der Harst, P., Bilo, H.J.G. and Zuurman, M.W. (2009) CCR5Delta32 Genotype Is Associated with Outcome in Type 2 Diabetes Mellitus. Diabetes Research and Clinical Practice, 86, 140-145.
http://dx.doi.org/10.1016/j.diabres.2009.08.013
[72] Lassner, D., Kuehl, U., Rohde, M., Siegismund, C.S. and Schultheiss, H.P. (2014) CCR5del32 Polymorphism Is a Protective Factor for Mortality in Non-Ischemic Cardiomyopathy. International Journal of Cardiology, 173, 561-562.
http://dx.doi.org/10.1016/j.ijcard.2014.03.123
[73] Kittleson, M.M. and Hare, J.M. (2005) Molecular Signature Analysis: Using the Myocardial Transcriptome as a Biomarker in Cardiovascular Disease. Trends in Cardiovascular Medicine, 15, 130-138.
http://dx.doi.org/10.1016/j.tcm.2005.05.007
[74] Siegismund, C.S., Rohde, M., Kühl, U. and Lassner, D. (2014) Multiparametric Diagnostics of Cardiomyopathies by microRNA Signatures. Microchimica Acta, in press.
http://dx.doi.org/10.1007/s00604-014-1249-y
[75] Lassner, D., Kuhl, U., Siegismund, C.S., Rohde, M., Elezkurtaj, S., Escher, F. and Schultheiss, H.P. (2014) Improved Diagnosis of Idiopathic Giant Cell Myocarditis and Cardiac Sarcoidosis by Myocardial Gene Expression Profiling. European Heart Journal, epub ahead of print.
http://dx.doi.org/10.1093/eurheartj/ehu101
[76] Elezkurtaj, S., Lassner, D., Schultheiss, H.P. and Escher, F. (2014) Vascular Involvement in Cardiac Giant Cell Myocarditis: A New Pathophysiological Aspect. Clinical Research in Cardiology: Official Journal of the German Cardiac Society, 103, 161-163.
http://dx.doi.org/10.1007/s00392-013-0638-2
[77] De Groote, P., Pinet, F. and Bauters, C. (2013) New Technologies, New Therapies: Toward Personalized Medicine in Heart Failure Patients? European Heart Journal, 34, 636-637.
http://dx.doi.org/10.1093/eurheartj/ehs432
[78] Ameling, S., Herda, L.R., Hammer, E., Steil, L., Teumer, A., Trimpert, C. and Felix, S.B. (2013) Myocardial Gene Expression Profiles and Cardiodepressant Autoantibodies Predict Response of Patients with dilated Cardiomyopathy to Immunoadsorption Therapy. European Heart Journal, 34, 666-675.
http://dx.doi.org/10.1093/eurheartj/ehs330
[79] Staudt, A., Dörr, M., Staudt, Y., Böhm, M., Probst, M., Empen, K. and Felix, S.B. (2005) Role of Immunoglobulin G3 Subclass in Dilated Cardiomyopathy: Results from Protein A Immunoadsorption. American Heart Journal, 150, 729-736.
http://dx.doi.org/10.1016/j.ahj.2004.11.002
[80] Ikeda, S., Kong, S.W., Lu, J., Bisping, E., Zhang, H., Allen, P.D. and Pu, W.T. (2007) Altered microRNA Expression in Human Heart Disease. Physiological Genomics, 31, 367-373.
http://dx.doi.org/10.1152/physiolgenomics.00144.2007
[81] Thum, T., Catalucci, D. and Bauersachs, J. (2008) MicroRNAs: Novel Regulators in Cardiac Development and Disease. Cardiovascular Research, 79, 562-570.
http://dx.doi.org/10.1093/cvr/cvn137
[82] Corsten, M.F., Papageorgiou, A., Verhesen, W., Carai, P., Lindow, M., Obad, S. and Heymans, S. (2012) MicroRNA Profiling Identifies microRNA-155 as an Adverse Mediator of Cardiac Injury and Dysfunction during Acute Viral Myocarditis. Circulation Research, 111, 415-425.
http://dx.doi.org/10.1161/CIRCRESAHA.112.267443
[83] Jaguszewski, M., Osipova, J., Ghadri, J.R., Napp, L.C., Widera, C., Franke, J. and Templin, C. (2014) A Signature of Circulating microRNAs Differentiates Takotsubo Cardiomyopathy from Acute Myocardial Infarction. European Heart Journal, 35, 999-1006.

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