In 1986, a group of 8 cardiac pathologists (who were known as the Dallas Panel), made an attempt to establish uniform criteria for the diagnosis of myocarditis in heart biopsy specimens. The “Dallas Criteria” were proposed in 1986, and provided microscopic categorization by which the diagnosis of myocarditis could be established.
The Dallas Criteria defined myocarditis as an inflammatory infiltrate and associated myocyte necrosis or damage not characteristic of an ischemic event. It defined a secondary category, “borderline myocarditis”, as a less intense inflammatory infiltrate and no evidence of myocyte damage. These criteria have been used exclusively by physicians over the past 3+ decades. Sampling error, variation in expert interpretation, variance with other markers of viral infection and immune activation in the heart, and variance with treatment outcomes all suggest that the Dallas Criteria are in need of revision.
The time has come to redefine viral and autoimmune heart disease with the use of methodologies available in the 21st century. Clinicians, pathologists, immunologists, and molecular cardiologists must contribute to the new criteria, which should include clinical presentation, histopathology, immunohistochemistry, viral polymerase chain reaction, cardiac antibody assessment, and imaging results.
(Taken from Circulation, AHA January 31, 2006)
Since then, much has taken place in the science of myocarditis diagnosis. On March 23rd, international myocarditis researchers and cardiac pathologists, from the Society for Cardiovascular Pathology (SCVP) and the Association for European Cardiovascular Pathology (AECVP) for will meet on the campus of Johns Hopkins Hospital in Baltimore, Maryland, to discuss new and revised criteria.
We look forward to the perspectives that will come from this meeting and the updated diagnostic criteria for myocarditis.
Sponsors of the event are: Moderna, Kiniksa Pharmaceuticals, Dr. Mary Ann Sens, and the Myocarditis Foundation.
