Hot Phases Cardiomyopathy: Pathophysiology, Diagnostic Challenges, and Emerging Therapies

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Date 2025 Jan 9

PMID 39786662

Authors

Giulia Bassetto

Federico Angriman

Carola Pio Loco Detto Gava

Alessia Paldino

Maria Perotto

Luca Bordignon

Marta Gigli

Matteo Dal Ferro

Laura Massa

Alessandro Altinier

Antonio De Luca

Gianfranco Sinagra

Marco Merlo

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Hot phases are a challenging clinical presentation in arrhythmogenic cardiomyopathy (ACM), marked by acute chest pain and elevated cardiac troponins in the absence of obstructive coronary disease. These episodes manifest as myocarditis and primarily affect young patients, contributing to a heightened risk of life-threatening arrhythmias and potential disease progression. This review aims to synthesize recent research on the pathophysiology, diagnostic challenges, and therapeutic management of hot phases in ACM.

Recent Findings: Hot phases have been linked to genetic mutations, particularly in desmosomal proteins such as Desmoplakin (DSP). Diagnostic challenges include differentiating hot phases from isolated acute myocarditis, through identification of red flags and a multimodal approach, including CMR, FDG-PET, endomyocardial biopsy and genetic testing. Emerging therapies, such as immunosuppressive and anti-inflammatory treatments, show promise in managing hot-phase episodes. Hot phases in ACM present a significant risk for arrhythmias and disease progression, necessitating a comprehensive diagnostic and therapeutic management. A multimodal diagnostic approach is essential for accurate diagnosis, but further research is needed to refine these strategies and improve prognosis for affected patients.

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