Evaluation of Myocardial Gene Expression Profiling for Superior Diagnosis of Idiopathic Giant-Cell Myocarditis and Clinical Feasibility in a Large Cohort of Patients with Acute Cardiac Decompensation
Standard
Evaluation of Myocardial Gene Expression Profiling for Superior Diagnosis of Idiopathic Giant-Cell Myocarditis and Clinical Feasibility in a Large Cohort of Patients with Acute Cardiac Decompensation. / Escher, Felicitas; Pietsch, Heiko; Aleshcheva, Ganna; Wenzel, Philip; Fruhwald, Friedrich; Stumpf, Christian; Westermann, Dirk; Bauersachs, Johann; Enseleit, Frank; Ruschitzka, Frank; Nägele, Herbert; Laugwitz, Karl-Ludwig; Haake, Hendrik; Frey, Norbert; Brachmann, Johannes; Huber, Kurt; Braun-Dullaeus, Rüdiger Christian; Bergmann, Martin W; Strotmann, Jörg; Grönefeld, Gerian; Krülls-Münch, Jürgen; Westenfeld, Ralf; Skurk, Carsten; Landmesser, Ulf; Pieske, Burkert; Gross, Ulrich M; Morawietz, Lars; Schultheiss, Heinz-Peter.
in: J CLIN MED, Jahrgang 9, Nr. 9, 19.08.2020.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Evaluation of Myocardial Gene Expression Profiling for Superior Diagnosis of Idiopathic Giant-Cell Myocarditis and Clinical Feasibility in a Large Cohort of Patients with Acute Cardiac Decompensation
AU - Escher, Felicitas
AU - Pietsch, Heiko
AU - Aleshcheva, Ganna
AU - Wenzel, Philip
AU - Fruhwald, Friedrich
AU - Stumpf, Christian
AU - Westermann, Dirk
AU - Bauersachs, Johann
AU - Enseleit, Frank
AU - Ruschitzka, Frank
AU - Nägele, Herbert
AU - Laugwitz, Karl-Ludwig
AU - Haake, Hendrik
AU - Frey, Norbert
AU - Brachmann, Johannes
AU - Huber, Kurt
AU - Braun-Dullaeus, Rüdiger Christian
AU - Bergmann, Martin W
AU - Strotmann, Jörg
AU - Grönefeld, Gerian
AU - Krülls-Münch, Jürgen
AU - Westenfeld, Ralf
AU - Skurk, Carsten
AU - Landmesser, Ulf
AU - Pieske, Burkert
AU - Gross, Ulrich M
AU - Morawietz, Lars
AU - Schultheiss, Heinz-Peter
PY - 2020/8/19
Y1 - 2020/8/19
N2 - AIMS: The diagnostic approach to idiopathic giant-cell myocarditis (IGCM) is based on identifying various patterns of inflammatory cell infiltration and multinucleated giant cells (GCs) in histologic sections taken from endomyocardial biopsies (EMBs). The sampling error for detecting focally located GCs by histopathology is high, however. The aim of this study was to demonstrate the feasibility of gene profiling as a new diagnostic method in clinical practice, namely in a large cohort of patients suffering from acute cardiac decompensation. Methods and Results: In this retrospective multicenter study, EMBs taken from n = 427 patients with clinically acute cardiac decompensation and suspected acute myocarditis were screened (mean age: 47.03 ± 15.69 years). In each patient, the EMBs were analyzed on the basis of histology, immunohistology, molecular virology, and gene-expression profiling. Out of the total of n = 427 patient samples examined, GCs could be detected in 26 cases (6.1%) by histology. An established myocardial gene profile consisting of 27 genes was revealed; this was narrowed down to a specified profile of five genes (CPT1, CCL20, CCR5, CCR6, TLR8) which serve to identify histologically proven IGCM with high specificity in 25 of the 26 patients (96.2%). Once this newly established profiling approach was applied to the remaining patient samples, an additional n = 31 patients (7.3%) could be identified as having IGCM without any histologic proof of myocardial GCs. In a subgroup analysis, patients diagnosed with IGCM using this gene profiling respond in a similar fashion to immunosuppressive therapy as patients diagnosed with IGCM by conventional histology alone. Conclusions: Myocardial gene-expression profiling is a promising new method in clinical practice, one which can predict IGCM even in the absence of any direct histologic proof of GCs in EMB sections. Gene profiling is of great clinical relevance in terms of a) overcoming the sampling error associated with purely histologic examinations and b) monitoring the effectiveness of therapy.
AB - AIMS: The diagnostic approach to idiopathic giant-cell myocarditis (IGCM) is based on identifying various patterns of inflammatory cell infiltration and multinucleated giant cells (GCs) in histologic sections taken from endomyocardial biopsies (EMBs). The sampling error for detecting focally located GCs by histopathology is high, however. The aim of this study was to demonstrate the feasibility of gene profiling as a new diagnostic method in clinical practice, namely in a large cohort of patients suffering from acute cardiac decompensation. Methods and Results: In this retrospective multicenter study, EMBs taken from n = 427 patients with clinically acute cardiac decompensation and suspected acute myocarditis were screened (mean age: 47.03 ± 15.69 years). In each patient, the EMBs were analyzed on the basis of histology, immunohistology, molecular virology, and gene-expression profiling. Out of the total of n = 427 patient samples examined, GCs could be detected in 26 cases (6.1%) by histology. An established myocardial gene profile consisting of 27 genes was revealed; this was narrowed down to a specified profile of five genes (CPT1, CCL20, CCR5, CCR6, TLR8) which serve to identify histologically proven IGCM with high specificity in 25 of the 26 patients (96.2%). Once this newly established profiling approach was applied to the remaining patient samples, an additional n = 31 patients (7.3%) could be identified as having IGCM without any histologic proof of myocardial GCs. In a subgroup analysis, patients diagnosed with IGCM using this gene profiling respond in a similar fashion to immunosuppressive therapy as patients diagnosed with IGCM by conventional histology alone. Conclusions: Myocardial gene-expression profiling is a promising new method in clinical practice, one which can predict IGCM even in the absence of any direct histologic proof of GCs in EMB sections. Gene profiling is of great clinical relevance in terms of a) overcoming the sampling error associated with purely histologic examinations and b) monitoring the effectiveness of therapy.
U2 - 10.3390/jcm9092689
DO - 10.3390/jcm9092689
M3 - SCORING: Journal article
C2 - 32825201
VL - 9
JO - J CLIN MED
JF - J CLIN MED
SN - 2077-0383
IS - 9
ER -