Micophenolate Mofetil Versus Azathioprine in Myocarditis

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• Inability to adequately control therapy and follow the research protocol (serious mental disorders, remoteness of residence, non-compliance of the patient)

Egyéb

• Patient refusal to participate in the study;
• Pregnancy;

• Presence of written informed consent of the patient to participate in the study;
• Age 18 and older;
• The diagnosis of myocarditis, established using endomyocardial biopsy (active or borderline myocarditis according to Dallas criteria, virus negative, excluding parvovirus B19);
• Chronic heart failure 2-4 according to New York Heart Association functional classification;
• Signs of left ventricular dysfunction, persisting after 2 months of optimal drug therapy (therapy for heart failure, including angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, beta-blockers, mineralocorticoid receptor antagonists, diuretics, angiotensin receptors and neprilysin inhibitors): end-diastolic the size of the left ventricle is more than 5.5 cm, the ejection fraction is less than 50%;
  • Non-inclusion criteria:
• History of myocardial infarction/acute coronary syndrome.
• Chronic ischemic heart disease with hemodynamically significant stenoses of the coronary arteries (70% or more).
• Congenital heart defects.
• History of infective endocarditis less than 6 months old.
• Thyrotoxic heart.
• Hypertensive heart (left ventricular hypertrophy more than 14 mm).
• Hypertrophic cardiomyopathy.
• Verified amyloidosis, sarcoidosis, other storage diseases.
• Diffuse connective tissue diseases.
• Verified systemic vasculitis.
• Lymphoproliferative diseases.
• Condition after chemotherapy with anthracycline drugs.
• Heart surgery less than 2 months old.