Infection and inflammation in the cardiovascular system.

Abstract

Infectious disease is one of the few genuine adventures left in the world. Hans Zinsser (1878–1940), Rats, Lice and History Infection and inflammation of the cardiovascular system are a frequent cause of cardiac and/or vascular disease, which represents an enormous clinical burden in adult medicine. Major advances have now occurred in understanding cellular and molecular bases of a wide variety of inflammatory cardiovascular diseases. Some of these (myocarditis) have been recognized as inflammatory disease for a long time. Of others (atherosclerosis), the inflammatory nature of disease and possible involvement of bacterial antigens therein has emerged only recently. In both cases however, new insights in inflammatory mechanisms will have great impact on clinical thinking and management. Therefore, Cardiovascular Research has decided to devote a spotlight issue to this topic. This issue contains 10 review articles that provide state-of-the-art knowledge and, in addition, 14 original papers with novel data on the intriguing relationship between infection/inflammation and cardiovascular disease. Historically, myocarditis has been the cause of a great deal of clinical and pathologic confusion and debate. Though the term myocarditis goes back to the 1800s, it was only in 1941 that histologic myocarditis was discerned from ischemic heart disease. Until the introduction of the endomyocardial bioptome in 1962, myocarditis was diagnosed during life often presumptive and not always correct, mainly in young patients with heart failure preceded by a febrile illness. Most cases were diagnosed as late as at autopsy. Confusion was further heightened by lack of agreement among clinicians regarding indications for endomyocardial biopsy as well as interpretation of biopsy findings. Histologic criteria for myocarditis are still a matter of debate among pathologists, and it has become now increasingly apparent that more attention should be given to serologic, molecular and immunologic factors in order to fully characterize the disease. According to the … *Corresponding author. Tel.: +31-20-566-5633; fax: +31-20-691-4738. Email address: a.c.vanderwal{at}amc.uva.nl