MECHANISMS OF IMMUNOLOGICALLY MEDIATED CA RDIAC DYSFUNCTION IN MYOCARDITIS AND DILATED CARDIOPATHY

Humoral and cellular effector mechanisms can influence the systolic an d diastolic cardiac function either transiently or permanently. These alterations can be triggered by molecular, metabolic, receptor-mediate d and structural alterations of myocytes (e.g., hypertrophy), the inte rstitial tissue and extracellular matrix (e.g., fibrosis) and of the c ellularity of non-cardiac cells (e.g., myocarditis). In this overview the emphasis lies on the description of alterations in inflammatory he art muscle diseases and the pathomechanisms by which, in experimental settings and human diseases, viruses, cytotoxic T cells, cytokines and anticardiac antibodies, influence these functional and structural pro cesses.