Infectious myocarditis: the role of the cardiac vasculature

Infectious myocarditis is the result of an immune response to a microbial infection of the heart. The blood vessels of the heart, both the intramyocardial microvasculature and the large epicardial coronary arteries, play an important role in the pathogenesis of infectious myocarditis. First of all,...

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Bibliographic Details
Published in:Heart failure reviews 2018-07, Vol.23 (4), p.583-595
Main Authors: Woudstra, Linde, Juffermans, Lynda J. M., van Rossum, Albert C., Niessen, Hans W. M., Krijnen, Paul A. J.
Format: Article
Language:English
Subjects:
Blood vessels
Cardiology
Cardiomyocytes
Coronary artery disease
Coronary Vessels - pathology
Endothelial cells
Endothelium, Vascular - pathology
Heart diseases
Humans
Immune response
Immune response (cell-mediated)
Infection - complications
Infection - pathology
Major histocompatibility complex
Medicine
Medicine & Public Health
Microvasculature
Myocardial infarction
Myocarditis
Myocarditis - etiology
Myocarditis - pathology
Myocytes, Cardiac - pathology
Pathogenesis
Perfusion
Thrombosis
Vasoconstriction
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Summary:Infectious myocarditis is the result of an immune response to a microbial infection of the heart. The blood vessels of the heart, both the intramyocardial microvasculature and the large epicardial coronary arteries, play an important role in the pathogenesis of infectious myocarditis. First of all, in addition to cardiomyocytes, endothelial cells of the cardiac (micro)vasculature are direct targets for infection. Moreover, through the expression of adhesion molecules and antigen presenting Major Histocompatibility Complex molecules, the blood vessels assist in shaping the cellular immune response in infectious myocarditis. In addition, damage and dysfunction of the cardiac (micro)vasculature are associated with thrombus formation as well as aberrant regulation of vascular tone including coronary vasospasm. These in turn can cause cardiac perfusion abnormalities and even myocardial infarction. In this review, we will discuss the role of the cardiac (micro)vasculature in the pathogenesis of infectious myocarditis.
ISSN:1382-4147
1573-7322
DOI:10.1007/s10741-018-9688-x