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Management of pericarditis and myocarditis: Could heart-rate-reducing drugs hold a promise?
MedLine Citation:
PMID:  24070595     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Rest is usually recommended in acute pericarditis and acute myocarditis. Given that myocarditis often leads to hospitalization, this task seems easy to carry out in hospital practice; however, it could be a real challenge at home in daily life. Heart rate-lowering treatments (mainly beta-blockers) are usually recommended in case of acute myocarditis, especially in case of heart failure or arrhythmias, but level of proof remains weak. Calcium channel inhibitors and digoxin are sometimes proposed, albeit in limited situations. It is possible that rest or even heart rate-lowering treatments could help to manage these patients by preventing heart failure as well as by limiting "mechanical inflammation" and controlling arrhythmias, especially life-threatening ones. Whether heart rate has an effect on inflammation remains unclear. Several questions remain unsolved, such as the duration of such treatments, especially in light of new heart rate-lowering treatments, such as ivabradine. In this review, we discuss rest and heart-rate lowering medications for the treatment of pericarditis and myocarditis. We also highlight some work in experimental models that indicates the beneficial effects of such treatments for these conditions. Finally, we suggest certain experimental avenues, through the use of animal models and clinical studies, which could lead to improved management of these patients.
Authors:
François Roubille; François Tournoux; Camille Roubille; Nolwenn Merlet; Jean-Marc Davy; Eric Rhéaume; David Busseuil; Jean-Claude Tardif
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-23
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  -     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Masson SAS. All rights reserved.
Affiliation:
Montreal Heart Institute, Université de Montréal, Montreal, Canada; Cardiology Department, University Hospital of Montpellier, Montpellier, France. Electronic address: francois.roubille@gmail.com.
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