Mending Broken Hearts

Name: Work Video:
Duration: 3 min 30 s
Bonnie L. Bermas; Vlad G. Zaha
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[306], 'has': [307, 810, 857, 1108], 'yielded': [308], 'cautious': [310], 'optimism': [311], 'recognition': [314, 623], 'commonly': [318], 'cause': [319, 648], 'immune-related': [320, 369, 430, 1342, 1563], 'adverse': [321, 370, 390, 431, 437, 1343, 1564], 'events': [322, 371, 391, 432, 1344, 1565], 'span': [324], 'spectrum': [326], 'organ': [328, 1360], 'systems.': [329], 'Among': [330, 702], 'rarer': [332], 'but': [333, 363, 1293], 'more': [334, 671, 1095, 1149], 'life-threatening': [335, 1243], 'is': [338, 346, 372, 473, 572, 591, 709, 728, 840, 847, 885, 971, 999, 1279, 1333], 'myocarditis.': [339, 725, 775], 'Management': [340, 933, 1561], 'myocarditis': [342, 360, 381, 471, 655, 714, 753, 809, 998, 1324], 'this': [344, 402, 734, 909, 927, 1458], 'setting': [345], 'challenging': [347], 'not': [348, 458, 972, 1214, 1461], 'only': [349], 'because': [350, 365, 922], 'there': [351], 'no': [353], 'clear': [354], 'guidelines': [355, 814, 921], 'management': [358, 377, 480, 806, 912, 1008, 1151, 1358, 1653], 'general': [362, 813, 920, 1068], 'also': [364], 'approach': [367, 387, 408, 824, 1005, 1152, 1400], 'uncharted': [373], 'territory.': [374], 'Thus': [375], 'far,': [376], 'strategies': [378], 'ICI-induced': [380, 470, 935, 997, 1136], 'relied': [383, 811], 'on': [384, 401, 416, 477, 785, 812, 1393, 1647], 'a': [385, 406, 451, 466, 517, 705, 1148, 1163, 1170, 1397, 1657], 'traditional': [386, 447], 'grading': [389, 403, 448], 'from': [392, 435, 538, 595, 657, 690, 715, 815, 1140, 1305, 1365, 1426, 1446, 1660], 'according': [395], 'symptom': [397], 'severity.': [398], 'Tactics': [399], 'based': [400], 'use': [405, 1093], 'step-wise': [407, 452], 'treatment': [410, 467, 945, 994, 1336], 'leads': [412], 'overreliance': [415], 'high-dose': [417, 827, 1188], 'glucocorticoid': [418], 'therapy,': [419], 'thus': [420], 'delaying': [421], 'initiation': [423, 761], 'steroid-sparing': [425, 1413], 'agents.2': [426], 'ICI': [429, 759, 1331, 1383], 'different': [434], 'other': [436, 558, 716, 1230, 1309], 'events.': [438], 'manifestations': [441, 658, 673], 'autoimmune': [443, 485, 495, 583], 'processes,': [444], 'applying': [446], 'systems': [449], 'increase': [453], 'medication': [455], 'recommendations': [456], 'may': [457, 872], 'be': [459, 527, 575, 792, 1286, 1300, 1372], 'best': [461, 1291], 'approach.': [462], 'Here,': [463], 'we': [464, 1138, 1185, 1220, 1247, 1419, 1431], 'propose': [465, 1130], 'paradigm': [468, 995], 'streamlined': [474], 'founded': [476], 'current': [479, 993], 'tenets': [481], 'prototypical': [484], 'condition,': [486], 'rheumatoid': [487, 1675], 'arthritis': [488], '(RA).Evidence': [489], 'suggests': [490], 'pathogenesis': [493], 'inflammatory': [496, 584], 'cardiomyopathy': [497, 694, 1391], 'involves': [498], 'interaction': [500], 'among': [501], 'innate': [503, 559], 'adaptive': [505], 'system,': [507], 'host': [508], 'genetics,': [509], 'environmental': [511], 'factors.': [512], 'In': [513, 1204, 1242, 1379], 'absence': [515, 800], 'causative': [518], 'pathogen': [519], '(ie,': [520], 'viral': [521, 724], 'myocarditis),': [522], 'cells': [524, 543, 561, 571, 590, 646], 'can': [525, 790, 1432, 1437], 'still': [526, 886], 'activated': [528, 539], 'by': [529, 621, 860, 1270, 1374], 'receptors': [530], 'recognize': [532], 'damage-associated': [533], 'molecular': [534], 'patterns.': [535], 'Downstream': [536], 'cardiomyocytes': [540], 'result': [544], 'release': [546], 'cytokines': [548], '(for': [549], 'example': [550], 'interleukin-1β)': [551], 'cascade': [553], 'recruitment': [556], 'myocardium.': [564], 'subsequent': [566], 'cytotoxic': [569, 644], 'T': [570, 645], 'considered': [573], 'main': [577], 'mechanism': [578], 'cardiac': [580, 676, 765, 795, 875, 902], 'damage': [581, 1117, 1362], 'cardiomyopathy.': [585], 'role': [587], 'B': [589], 'less': [592, 1115], 'established,': [593], 'inferred': [594], 'detection': [597], 'autoantibodies': [599], 'against': [600], 'myocardial': [601, 780, 906], 'proteins.': [602], 'Inhibitory': [603], 'signals,': [604], 'is,': [606], 'checkpoints,': [608, 638], 'keep': [609], 'balance': [611], 'amplitude': [613], 'pattern': [615], 'response': [619], 'initiated': [620], 'antigen': [622], 'through': [624], 'receptor.3': [627], 'targeting': [629], 'CTLA4,': [631], 'PD1,': [632], 'pathways': [635], 'unfetter': [636], 'leading': [639, 1161], 'unbridled': [641], 'direct': [649], 'heart': [650, 870], 'damage.The': [651], 'presentation': [653, 867], 'ranges': [656], 'such': [659, 674, 718, 868, 1226, 1311], 'chest': [661], 'pain,': [662], 'shortness': [663], 'breath,': [665], 'fatigue,': [666], 'palpitations': [668], 'even': [670], 'severe': [672], 'arrhythmias,': [677], 'cardiogenic': [678], 'shock,': [679], 'sudden': [681], 'death.': [682], 'Initial': [683], 'diagnostic': [684], 'tests': [685], 'aim': [686], 'differentiate': [688, 712], 'ischemic': [689], 'nonischemic': [691], 'causes': [692], 'stratify': [697], 'acuity': [699], 'presentation.': [701], 'fulminant': [706, 866, 1655], 'presentation,': [707], 'it': [708, 884, 1018], 'important': [710, 1287], 'ICI-associated': [713, 808], 'types': [717], 'eosinophilic,': [720], 'giant': [721], 'cell,': [722], 'Endomyocardial': [726], 'biopsy': [727, 745], 'gold': [730], 'standard': [731], 'test': [732], 'purpose': [735], 'classic': [737], 'histology': [738], 'immunohistochemistry': [740], 'adding': [741, 1038, 1263], 'sensitivity': [742], 'results.': [746], 'Most': [747], 'often,': [748], 'symptoms': [750, 1212], 'suggestive': [751], '1': [754, 1182], '2': [756, 963, 975], 'months': [757], 'after': [758, 852, 962, 974], 'elevation': [763], 'troponins': [766], 'sufficient': [768], 'raise': [770], 'concern': [773], 'extent': [777], 'inflammation': [781], 'impact': [784], 'left': [787, 894], 'ventricular': [788, 895], 'contractility': [789], 'then': [791, 844, 1041], 'established': [793], 'magnetic': [796], 'resonance': [797], 'imaging.In': [798], 'evidence-based': [802, 938], 'data,': [803], 'oncology': [817, 1427], 'community': [818], '(Figure': [819, 1176], '[A]).': [820], 'follow': [822], 'recommends': [826], 'steroids': [828, 1253], 'tapering': [830, 982, 1274], 'doses': [831], 'over': [832], '4': [833, 1218, 1245], '5': [835], 'weeks.': [836], 'If': [837], 'disease': [839, 1103, 1159, 1167, 1278], 'refractory': [841], 'recommendation': [846], 'add': [849], 'immunosuppressive': [850, 1399], 'agents': [851, 1081, 1414], 'several': [853], 'weeks.2': [854], 'This': [855, 1046], 'strategy': [856, 1107, 1275], 'endorsed': [859], 'cardiologists': [861], 'well.4': [863], 'Patients': [864], 'failure': [871], 'require': [873], 'intense': [874], 'care,': [876], 'including': [877], 'inotropic': [878], 'mechanical': [880], 'circulatory': [881], 'support.': [882], 'unclear': [887], 'how': [888, 899], 'manage': [890, 1353], 'preserved': [893], 'ejection': [896], 'fraction': [897], 'apply': [901, 1147], 'therapies': [903], 'prevent': [905], 'remodeling': [907], 'setting.': [910], 'Similarly,': [911], 'both': [914], 'bradyarrhythmias': [915], 'tachyarrhythmias': [917], 'follows': [918], 'existing': [919], 'prospective': [924], 'studies': [925], 'area': [928], 'lacking.Download': [930], 'figureDownload': [931], 'PowerPointFigure.': [932], 'myocarditis.A.': [936], 'Current': [937], 'therapy.2B': [939], 'C,': [941, 1542, 1596], 'Proposed': [942], 'new': [943], 'tiered': [944], 'paradigm.': [946], '*Consider': [947], 'addition': [948], 'mycophenolate': [950, 967, 1234], 'mofetil,': [951, 1235], 'infliximab,': [952], 'antithymocyte': [954], 'globulin.': [955], '**Escalate': [956], 'intravenous': [958, 1236], 'immunoglobulin': [959], 'antithymoglobulin': [961], 'cycles.': [964], '***Escalate': [965], 'mofetil': [968], 'if': [969, 1211], 'patient': [970], 'responding': [973], 'cycles': [976], 'abatacept.': [978], 'Downward': [979], 'arrow': [980], 'indicates': [981], 'dose': [983], 'prednisone;': [985], 'ICI,': [986], 'inhibitor;': [989], 'PLEX,': [991], 'plasmapheresis.The': [992], 'reminiscent': [1000], 'hierarchical': [1003], 'pyramid': [1004, 1086], 'RA': [1010, 1074, 1111, 1145], 'was': [1012, 1019, 1087], 'used': [1013], 'years': [1016], 'before': [1017], 'abandoned.': [1020], 'Until': [1021], '1990s,': [1023], 'rheumatologists': [1024], 'would': [1025], 'gingerly': [1026], 'accelerate': [1027], 'RA,': [1030], 'starting': [1031, 1187], 'nonsteroidal': [1033], 'anti-inflammatory': [1034], 'gradually': [1037], 'glucocorticoids': [1039, 1189], 'available': [1042, 1155], 'disease-modifying': [1043, 1097], 'antirheumatic': [1044, 1098], 'drugs.': [1045], 'sluggish': [1047], 'tactic': [1048], 'came': [1049], 'at': [1050, 1158, 1199], 'cost': [1052], 'significant': [1054], 'symptoms,': [1056], 'impaired': [1057], 'function,': [1058], 'irreversible': [1060], 'joint': [1061, 1116], 'damage.': [1062], 'approval': [1066], 'acceptance': [1069], 'methotrexate': [1071, 1197], 'subsequently': [1076], 'very': [1078], 'effective': [1079], 'biological': [1080, 1224, 1264, 1416], 'small': [1083], 'molecules,': [1084], 'inverted,': [1088], 'experts': [1090], 'advocating': [1091], 'aggressive': [1096, 1150, 1272], 'early': [1100], 'course.5': [1104], 'latter': [1106], 'drastically': [1109], 'improved': [1110], 'outcomes': [1112], 'significantly': [1114, 1215], 'accrual,': [1118], 'improvement': [1119], 'quality': [1121], 'life,': [1123], 'decreased': [1124, 1127], 'disability,': [1125], 'mortality.': [1128], 'We': [1129], 'that,': [1131], 'case': [1134, 1206, 1381], 'myocarditis,': [1137, 1210, 1246, 1384], 'learn': [1139], "rheumatologists'": [1142], 'experience': [1143], 'uses': [1154], 'immunomodulatory': [1156, 1231], 'recognition,': [1160], 'higher': [1164], 'likelihood': [1165], 'control': [1168], 'reduction': [1171], 'morbidity': [1173], 'mortality': [1175], '[B': [1177], 'C]).': [1179], 'For': [1180], 'grades': [1181], '2,': [1184], 'recommend': [1186, 1221, 1248], '(1': [1190, 1254], 'mg/kg': [1191], 'prednisone': [1192, 1273], 'equivalent)': [1193], 'while': [1194], 'concurrently': [1195], 'initiating': [1196, 1249], '15': [1200], '20': [1202], 'mg/wk.': [1203], 'grade': [1208, 1244], '3': [1209, 1258], 'do': [1213], 'improve': [1216], 'within': [1217], 'weeks,': [1219], 'escalation': [1222], 'abatacept': [1228, 1320], '(eg,': [1233, 1266], 'immunoglobulin,': [1237], 'tumor': [1238], 'necrosis': [1239], 'factor-α': [1240], 'blockade).': [1241], 'pulse': [1252], 'g/d': [1255], 'methylprednisolone': [1256], 'days)': [1259], 'plasmapheresis': [1261], 'abatacept)': [1267], 'up-front,': [1268], 'followed': [1269], 'once': [1276], 'under': [1280], 'control.': [1281], 'Ultimately,': [1282], 'trials': [1284, 1307], 'will': [1285, 1297], 'identifying': [1289], 'approach,': [1292], 'until': [1294], 'then,': [1295], 'providers': [1296], 'need': [1298], 'flexible': [1301], 'extrapolate': [1303], 'data': [1304], 'disciplines': [1310], 'ongoing': [1314], 'study': [1315], 'activator': [1319], 'RA-associated': [1322], 'subclinical': [1323], '(URL:': [1325], 'http://www.clinicaltrials.gov.': [1326], 'Unique': [1327], 'identifier:': [1328], 'NCT03619876).In': [1329], 'conclusion,': [1330], 'mainstream': [1335], 'cancers.': [1339], 'associated': [1341], 'occur': [1346], 'necessitate': [1347], 'involvement': [1348], 'multidisciplinary': [1350], 'teams': [1351], 'patients.': [1355], 'Although': [1356], 'requires': [1363], 'input': [1364, 1425], 'organ-specific': [1366], 'subspecialists,': [1367], 'modulation': [1370], 'should': [1371, 1401], 'implemented': [1373], 'clinicians': [1375], 'comfortable': [1376], 'immunotherapy.': [1378], 'understanding': [1385], 'managing': [1387], 'physiology': [1389], 'depend': [1392], 'cardiology': [1394], 'expertise.': [1395], 'Designing': [1396], 'rational': [1398], 'rheumatology': [1403], 'immunology': [1405], 'specialists': [1406, 1428], 'familiar': [1407], 'medications,': [1410], 'particular': [1412], 'therapy.': [1417], 'Lastly,': [1418], 'cannot': [1420], 'overstate': [1421], 'importance': [1423], 'so': [1429], 'ensure': [1433], 'our': [1435], 'continue': [1438], 'their': [1439], 'treatment.Disclosures': [1441], 'Dr': [1442], 'received': [1444], 'support': [1445], 'Prevention': [1449], 'Institute': [1451], '(RP180404).FootnotesThe': [1454], 'opinions': [1455], 'expressed': [1456], 'article': [1459], 'necessarily': [1462], 'those': [1463], 'editors': [1466], 'American': [1470, 1574, 1636, 1662, 1706], 'Heart': [1471, 1609, 1637, 1639, 1663, 1707, 1720], 'Association.https://www.ahajournals.org/journal/circBonnie': [1472], 'bonnie.[email': [1497], 'protected]eduVlad': [1498], 'vlad.[email': [1521], 'protected]eduReferences1.': [1522], 'Robert': [1523], 'A': [1525], 'decade': [1526], 'immune-checkpoint': [1528], 'therapy.Nat': [1532], 'Commun.': [1533], '2020;': [1534, 1611, 1665], '11:3801.': [1535], 'doi:': [1536, 1586, 1613, 1667, 1686], '10.1038/s41467-020-17670-yCrossrefMedlineGoogle': [1537], 'Scholar2.': [1538], 'Brahmer': [1539], 'JR,': [1540], 'Lacchetti': [1541], 'Schneider': [1543], 'BS,': [1544], 'Atkins': [1545], 'MB,': [1546], 'Brassil': [1547], 'KJ,': [1548], 'Caterino': [1549], 'JM,': [1550, 1556], 'Chau': [1551], 'I,': [1552], 'Ernstoff': [1553], 'MS,': [1554], 'Gardner': [1555], 'Ginex': [1557], 'P,': [1558], 'et': [1559], 'al..': [1560], 'treated': [1568], 'inhibitor': [1572, 1601], 'therapy:': [1573], 'Society': [1575], 'Clinical': [1577, 1579, 1648], 'Oncology': [1578], 'Practice': [1580], 'Guideline.J': [1581], 'Clin': [1582], 'Oncol.': [1583], '2018;': [1584], '36:1741–1768.': [1585], '10.1200/JCO.2017.77.6385CrossrefGoogle': [1587], 'Scholar3.': [1588], 'Palaskas': [1589], 'N,': [1590], 'Lopez-Mattei': [1591], 'J,': [1592], 'Durand': [1593], 'JB,': [1594], 'Iliescu': [1595], 'Deswal': [1597], 'A.': [1598], 'myocarditis:': [1602, 1656], 'pathophysiological': [1603], 'characteristics,': [1604], 'diagnosis,': [1605], 'treatment.J': [1607], 'Am': [1608], 'Assoc.': [1610], '9:e013757.': [1612], '10.1161/JAHA.119.013757LinkGoogle': [1614], 'Scholar4.': [1615], 'Kociol': [1616], 'RD,': [1617], 'Cooper': [1618], 'LT,': [1619], 'Fang': [1620], 'JC,': [1621], 'Moslehi': [1622], 'JJ,': [1623], 'Pang': [1624], 'PS,': [1625], 'Sabe': [1626], 'MA,': [1627], 'Shah': [1628], 'RV,': [1629], 'Sims': [1630], 'DB,': [1631], 'Thiene': [1632], 'G,': [1633], 'Vardeny': [1634], 'O;': [1635], 'Association': [1638], 'Failure': [1640], 'Transplantation': [1642], 'Committee': [1643], 'Council': [1646], 'Cardiology.': [1649], 'Recognition': [1650], 'initial': [1652], 'scientific': [1658], 'statement': [1659], 'Association.Circulation.': [1664], '141:e69–e92.': [1666], '10.1161/CIR.0000000000000745LinkGoogle': [1668], 'Scholar5.': [1669], 'van': [1670], 'Vollenhoven': [1671], 'RF.': [1672], 'arthritis:': [1676], 'state': [1677], 'art': [1680], '2009.Nat': [1681], 'Rev': [1682], 'Rheumatol.': [1683], '2009;': [1684], '5:531–541.': [1685], '10.1038/nrrheum.2009.182CrossrefMedlineGoogle': [1687], 'Scholar': [1688], 'Previous': [1689], 'Back': [1690], 'top': [1692], 'Next': [1693], 'FiguresReferencesRelatedDetails': [1694], 'February': [1695], '23,': [1696], '2021Vol': [1697], 'Issue': [1699], '8Article': [1700], 'InformationMetrics': [1701], 'Download:': [1702], '1,678': [1703], '©': [1704], '2021': [1705, 1714], 'Association,': [1708], 'Inc.https://doi.org/10.1161/CIRCULATIONAHA.120.052307PMID:': [1709], '33617309': [1710], 'publishedFebruary': [1712], '22,': [1713], 'Keywordsimmune': [1715], 'inhibitorsmyocarditisPDF': [1717], 'download': [1718], 'SubjectsInflammatory': [1719], 'DiseaseCardio-OncologyCardiomyopathy': [1721]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W3132726729', 'counts_by_year': [{'year': 2023, 'cited_by_count': 2}, {'year': 2022, 'cited_by_count': 3}], 'updated_date': '2024-12-31T14:35:34.510188', 'created_date': '2021-03-01'}
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