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Myocardial and Pericardial Diseases

Position papers and consensus documents from the Working Group on Myocardial and Pericardial Diseases

The Working Group on Myocardial and Pericardial Diseases is involved in many scientific publications.

Position papers and recommendations of interest have been written for professionals and scientists involved in managing of heart muscle and pericardial disease.

Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice

A position statement of the ESC working group on myocardial and pericardial diseases

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Authors: Yigal M. Pinto, Perry M. Elliott, Eloisa Arbustini, Yehuda Adler, Aris Anastasakis, Michael Böhm, Denis Duboc, Juan Gimeno, Pascal de Groote, Massimo Imazio, Stephane Heymans, Karin Klingel, Michel Komajda, Giuseppe Limongelli, Ales Linhart, Jens Mogensen, James Moon, Petronella G. Pieper, Petar M. Seferovic, Stephan Schueler, Jose L. Zamorano, Alida L.P. Caforio, Philippe Charron

European Heart Journal DOI: 10.1093/eurheartj/ehv727; First published online: 19 January 2016


Triage strategy for urgent management of cardiac tamponade

A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases 

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Eur Heart J (2014) doi: 10.1093/eurheartj/ehu217 First published online: July 7, 2014

Authors: Arsen D. Ristic,Massimo Imazio2, Yehuda Adler, Aristides Anastasakis, Luigi P. Badano, Antonio Brucato, Alida L. P. Caforio, Olivier Dubourg, Perry Elliott, Juan Gimeno, Tiina Helio, Karin Klingel, Aleš Linhart, Bernhard Maisch, Bongani Mayosi, Jens Mogensen, Yigal Pinto, Hubert Seggewiss, Petar M. Seferović, Luigi Tavazzi, Witold Tomkowski and Philippe Charron.

Abstract: Prompt recognition of cardiac tamponade is critical since the underlying haemodynamic disorder can lead to death if not resolved by percutaneous or surgical drainage of the pericardium. Cardiac tamponade is a condition caused by the compression of the heart due to slow or rapid accumulation of fluid (exudate), pus, blood, clots, or gas within the pericardial space resulting in impaired diastolic filling and cardiac output due to increased intrapericardial pressure. Pericardial diseases of any aetiology may cause cardiac tamponade, but with highly variable incidence reflecting the local epidemiological background (Table 1).However, all interventional procedures (i.e. percutaneous coronary intervention, transcatheter aortic valve implantation, pacemaker/implantable cardioverter defibrillator implantation, arrhythmias ablation, endomyocardial biopsy) are emerging causes of cardiac tamponade.7 Although rare, cardiac tamponade may also occur in pregnancy and in post-partum. Thus cardiologists should be aware of this possibility including specific contraindications for pregnancy (i.e. avoid the use of colchicine and X-ray exposure using echo-guided procedure).

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

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Eur Heart J. 2013 Jul 3. [Epub ahead of print] PubMed PMID: 23824828.

Authors: Alida L. P. Caforio, Sabine Pankuweit, Eloisa Arbustini, Cristina Basso, Juan Gimeno-Blanes, Stephan B. Felix, Michael Fu, Tiina Heliö, Stephane Heymans, Roland Jahns, Karin Klingel, Ales Linhart, Bernhard Maisch, William McKenna, Jens Mogensen, Yigal M. Pinto, Arsen Ristic, Heinz-Peter Schultheiss, Hubert Seggewiss, Luigi Tavazzi, Gaetano Thiene, Ali Yilmaz, Philippe Charron and Perry M. Elliott

Abstract: In this position statement of the ESC Working Group on Myocardial and Pericardial Diseases an expert consensus group reviews the current knowledge on clinical presentation, diagnosis and treatment of myocarditis, and proposes new diagnostic criteria for clinically suspected myocarditis and its distinct biopsy-proven pathogenetic forms. The aims are to bridge the gap between clinical and tissue-based diagnosis, to improve management and provide a common reference point for future registries and multicentre randomised controlled trials of aetiology-driven treatment in inflammatory heart muscle disease.

Diagnostic work-up in cardiomyopathies: bridging the gap between clinical phenotypes and final diagnosis

A position statement from the ESC Working Group on Myocardial and Pericardial Diseases

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Eur Heart J. 2012 Dec 4. [Epub ahead of print] PubMed PMID: 23211230

Authors: Claudio Rapezzi, Eloisa Arbustini, Alida L. P. Caforio, Philippe Charron, Juan Gimeno-Blanes, Tiina Heliö, Ales Linhart, Jens Mogensen, Yigal Pinto, Arsen Ristic, Hubert Seggewiss, Gianfranco Sinagra, Luigi Tavazzi and Perry M. Elliott

Abstract: In 2008, The ESC Working Group on Myocardial and Pericardial Diseases proposed an updated classification of cardiomyopathies based on morphological and functional phenotypes and subcategories of familial/genetic and non-familial/non-genetic disease. In this position statement, we propose a framework for the clinical approach to diagnosis in cardiomyopathies based on the recognition of diagnostic ‘red flags’ that can be used to guide rational selection of specialized tests including genetic analysis. The basic premise is that the adoption of a cardiomyopathy-specific mindset which combines conventional cardiological assessment with non-cardiac and molecular parameters increases diagnostic accuracy and thus improves advice and treatment for patients and families.

Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy

A position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy

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Eur J Heart Fail (2010) 12 (8): 767-778; doi: 10.1093/eurjhf/hfq120

Authors: Karen Sliwa, Denise Hilfiker-Kleiner, Mark C. Petrie, Alexandre Mebazaa, Burkert Pieske, Eckhart Buchmann, Vera Regitz-Zagrosek, Maria Schaufelberger, Luigi Tavazzi, Dirk J. van Veldhuisen, Hugh Watkins, Ajay J. Shah, Petar M. Seferovic, Uri Elkayam, Sabine Pankuweit, Zoltan Papp, Frederic Mouquet and John J.V. McMurray

Abstract: Peripartum cardiomyopathy (PPCM) is a cause of pregnancy-associated heart failure. It typically develops during the last month of, and up to 6 months after, pregnancy in women without known cardiovascular disease. The present position statement offers a state-of-the-art summary of what is known about risk factors for potential pathophysiological mechanisms, clinical presentation of, and diagnosis and management of PPCM. A high index of suspicion is required for the diagnosis, as shortness of breath and ankle swelling are common in the peripartum period. Peripartum cardiomyopathy is a distinct form of cardiomyopathy, associated with a high morbidity and mortality, but also with the possibility of full recovery. Oxidative stress and the generation of a cardiotoxic subfragment of prolactin may play key roles in the pathophysiology of PPCM. In this regard, pharmacological blockade of prolactin offers the possibility of a disease-specific therapy.

Classification of the cardiomyopathies

A position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases

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Eur. Heart J., January 2008; 29: 270 - 276.

Authors: Perry Elliott, Bert Andersson, Eloisa Arbustini, Zofia Bilinska, Franco Cecchi, Philippe Charron, Olivier Dubourg, Uwe Kühl, Bernhard Maisch, William J. McKenna, Lorenzo Monserrat, Sabine Pankuweit, Claudio Rapezzi, Petar Seferovic, Luigi Tavazzi, and Andre Keren

Abstract: In biology, classification systems are used to promote understanding and systematic discussion through the use of logical groups and hierarchies. In clinical medicine, similar principles are used to standardise the nomenclature of disease. For more than three decades, heart muscle diseases have been classified into primary or idiopathic myocardial diseases (cardiomyopathies) and secondary disorders that have similar morphological appearances, but which are caused by an identifiable pathology such as coronary artery disease or myocardial infiltration (specific heart muscle diseases). In this document, The European Society of Cardiology Working Group on Myocardial and Pericardial Diseases presents an update of the existing classification scheme. The aim is to help clinicians look beyond generic diagnostic labels in order to reach more specific diagnoses.

Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy

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ESC Practice Guidelines - 2003

Authors: B.J.Maron and W.J.McKenna (Chairpersons), G.K.Danielson, L.J.Kappenberger, H.J.Kuhn, C.E.Seidman, P.M.Shah, W.H.Spencer III, P.Spirito, F.J. Ten Cate, E.D.Wigle