Serum Thioredoxin and α-Tocopherol Concentrations in Patients With Major Risk Factors
スポンサーリンク
概要
- 論文の詳細を見る
Background Oxidative stress, which is thought to be increased in subjects with various coronary risk factors, induces thioredoxin (TRX), a redox-active protein. Methods and Results To determine whether oxidative stress is increased, serum concentrations of both TRX and α-tocopherol (vitamin E) were determined in 12 control subjects without any coronary risk factors (CONTROL), 6 current smokers (SMOKING), 19 hypertensive patients (HT), 7 hypercholesterolemic patients (HC) and 14 subjects with multiple risk factors (MULTIPLE). Patients with diabetes mellitus were not included. The serum TRX concentrations (mean±SD ng/ml) were significantly higher in SMOKING (41±10), HT (41±17), HC (48±15) and MULTIPLE (46±15) than in CONTROL (24±11). The serum α-tocopherol concentrations (mg/g lipids) were not significantly different among CONTROL (4.0±0.7), SMOKING (4.0±0.8), HT (4.1±0.6) and HC (4.2±0.6), although the concentration was significantly lower in MULTIPLE (3.3±0.7) than in any of the other study groups. Conclusions SMOKING, HT, HC and MULTIPLE had significantly higher serum TRX concentrations than CONTROL, suggesting increased oxidative stress. MULTIPLE had a lower serum concentration of antioxidant α-tocopherol than any of the other study groups, suggesting impaired or exhausted defense against chronic oxidative stress in the presence of the multiple risk factors.
- 社団法人日本循環器学会の論文
- 2005-02-20
著者
-
KISHIMOTO Chiharu
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
-
YODOI Junji
Institute for Virus Research, Kyoto University
-
Kishimoto Chiharu
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
-
Kishimoto Chiharu
京都大学 循環器内科学
-
Kishimoto Chiharu
Department Of Cardiology Shizuoka Central Prefectural Hospital Shizuoka
-
Okuda Nobuaki
Cardiovascular Division Kansai Electric Power Hospital
-
Kishimoto Chiharu
The Third Division Department Of Internal Medicine Faculty Of Medicine Kyoto University
-
Yodoi Junji
Institute Of Virus Research Kyoto University
-
Ishii Katsuhisa
Cardiovascular Division Kansai Electric Power Hospital
-
Miwa Kunihisa
Division of Medicine, Hamamatsu Rosai Hospital, Shizuoka
-
Nakamura Hajime
Institute of Virus Research, Kyoto University
-
Makita Toshinori
Cardiovascular Division, Kansai Electric Power Hospital
-
Sasayama Shigetake
Division of Medicine, Hamamatsu Rosai Hospital, Shizuoka
-
Miwa Kunihisa
Division Of Medicine Hamamatsu Rosai Hospital Shizuoka
-
Sasayama Shigetake
The Third Division Of Medicine Kyoto University
-
Kishimoto Chiharu
Third Division Of Internal Medicine Kyoto Univercity Hospital.
-
Kishimoto C
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
-
Makita Toshinori
Cardiovascular Division Kansai Electric Power Hospital
-
Makita Toshinori
Cardiovascular Center Osaka Red Cross Hospital
-
Sasayama Shigetake
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
-
Sasayama Shigetake
Division Of Medicine Hamamatsu Rosai Hospital Shizuoka
-
Sasayama Shigetake
Department Of Cardiology Doshisha University
-
Saijyo Sayaka
The Department Of Cardiology Hyogo Prefectural Amagasaki Hospital
-
Yodoi Junji
Institute For Immunology Kyoto University Faculty Of Medicine
-
Nakamura Hajime
Institute Of Virus Research Kyoto University
-
Nakamura Hajime
Institute For Virus Research Kyoto University
-
Miwa Kunihisa
Division Of Cardiovascular Medicine Takeda General Hospital
-
Kishimoto Chiharu
京都大学 医学研究科 循病態
-
Sasayama Shigetake
Thesecond Department Of Internal Medicine Toyama Medical And Pharmaceutical University
-
Sawada Shigeo
Division Of Medicine Hamamatsu Rosai Hospital Shizuoka
-
SASAYAMA Shigetake
Division of Cardiac Electrophysiology, the Third Department of Internal Medicine, Faculty of Medicine, Kyoto University
関連論文
- N-Acetylcysteine Reduces the Severity of Atherosclerosis in Apolipoprotein E-Deficient Mice by Reducing Superoxide Production
- PE-132 Induction of Vulnerable Plaques by Marble-Burying Behavior and Their Stabilization by Exercise Training in Experimental Atherosclerosis(PE023,Coronary Revascularization, PCI (DES) 3 (IHD),Poster Session (English),The 73rd Annual Scientific Meeting
- PE-026 Swimming Reduces the Severity of Atherosclerosis in Apolipoprotein E Deficient Mice by Antioxidant Effects(Atherosclerosis, basic(03)(IHD),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- Exercise Training Reduces Severity of Atherosclerosis in Apolipoprotein E Knockout Mice via Nitric Oxide
- Involvement of thioredoxin-binding protein 2 in the antitumor activity of CD437
- PE-132 Induction of Vulnerable Plaques by Marble-Burying Behavior and Their Stabilization by Exercise Training in Experimental Atherosclerosis(PE023,Coronary Revascularization, PCI (DES) 3 (IHD),Poster Session (English),The 73rd Annual Scientific Meeting
- DPE-011 Naloxone, an Opiate Receptor Antagonist, Ameliorates Acute Heart Failure in Experimental Autoimmune Myocarditis by Reducing Cytotoxic Activities(DPE02,Heart Failure, Basic (M),Digital Poster Session (English),The 73rd Annual Scientific Meeting of
- DPE-011 Naloxone, an Opiate Receptor Antagonist, Ameliorates Acute Heart Failure in Experimental Autoimmune Myocarditis by Reducing Cytotoxic Activities(DPE02,Heart Failure, Basic (M),Digital Poster Session (English),The 73rd Annual Scientific Meeting of
- Effects of Postischemic Regional Left Ventricular Diastolic Wall Motion Abnormalities or Delayed Relaxation Following Coronary Vasospasm on Global Diastolic Function
- Serum Thioredoxin and α-Tocopherol Concentrations in Patients With Major Risk Factors
- Diagnosis of Multivessel Coronary Vasospasm by Detecting Postischemic Regional Left Ventricular Delayed Relaxation on Echocardiography Using Color Kinesis
- Coincidence between multiple regional diastolic stunned myocardium detected by Color Kinesis and multivessel coronary vasospasm induced by intracoronary acetylcholine
- Exercise-induced prominent U waves as a marker of critical narrowing of LCX or RCA with well-developed and well-functioning collateral vessels
- Serum thioredoxin levels in patients with coronary vasospasm and in subjects with various risk factors
- PE-132 Induction of Vulnerable Plaques by Marble-Burying Behavior and Their Stabilization by Exercise Training in Experimental Atherosclerosis(PE023,Coronary Revascularization, PCI (DES) 3 (IHD),Poster Session (English),The 73rd Annual Scientific Meeting
- PE-422 Immunoglobulin Treatment Suppresses Oxidative Stress-Mediated Myocardial Injury in Autoimmune Heart Failure(Heart failure, basic(04)(M),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-042 Therapy With Immunoglobulin Prevents Acute Death in Patients With Fulminant Myocarditis(Cardiomyopathy, basic/clinical(03)(M),Poster Session(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-258 An Experimental Model of in Vitro Autoimmune-mediated Myocardial Damage in Myocarditis(Myocarditis, basic/clinical-1, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-257 Antibody-Mediated Infectious Enhancement via Fc receptors in Murine Coxsackievirus B3 Myocarditis(Myocarditis, basic/clinical-1, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- PE-128 Effects of MCI-186 (edaravone), a Novel Free Radical Scavenger, upon Experimental Atherosclerosis in Apolipoprotein E-Deficient Mice(Atherosclerosis, basic-6, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- OE-075 Immunoglobulin Suppresses Experimental Atherosclerosis via the Fc Portion Independent of Hypercholesterolemia(Atherosclerosis, basic-1, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- FRS-028 Generalized Oxidative Stress Overload is Present in Patients with Heart Failure(Clinical Heart Failure-Pathophysiology and Treatment, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Effects of MCI-186 (Edaravone), a Novel Free Radical Scavenger, Upon Experimental Atherosclerosis in Apolipoprotein E-Deficient Mice
- PJ-765 Carvedilol Protects against Autoimmune Heart Failure by Antioxidant Actions, But Not by Beta Blocking Effects(Heart failure, basic-8 (M) PJ132,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Soci
- PE-429 Immunoglobulin Administration Ameliorated Left Ventricular Function in Patients with Myocarditis by Reducing Oxidative Stress(Myocarditis, basic/clinical-2 (M) PE72,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japa
- PE-428 Peroxisome Proliferation-Activated Receptor-γ Ligands Ameliorate Experimental Autoimmune Myocarditis(Myocarditis, basic/clinical-2 (M) PE72,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society)
- PE-183 Myocardial Oxidative Stress is Increased in Patients with Cardiomyopathies(Cardiomyopathy, basic/clinical-4 (M) PE31,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society)
- OE-288 Immunoglobulin Suppressed Autoimmune Myocarditis in Severe Combined Immunodeficient (SCID) Mice by Inducing T Cell Unresponsiveness(Myocarditis, basic/clinical-1 (M) OE49,Oral Presentation (English),The 70th Anniversary Annual Scientific Meeting of
- Effects of Late Administration of Immunoglobulin on Experimental Atherosclerosis in Apolipoprotein E-Deficient Mice
- Significance of Pericardial Cytokines in Myocarditis (Myocarditis, Basic/Clinical 2 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- DNA Damage Is Increased in the Failing Human Myocardium Due to Myocarditis and Cardiomyopathies
- Immunoglobulin Suppressed Adoptively Transferred Autoimmune Myocarditis in Severe Combined Immunodeficient Mice : A Novel Suppressive Effect of Immunoglobulin on T Cells
- 28) PROGNOSIS OF IDIOPATHIC CARDIOMYOPATHY: ANALYSIS OF MULTICENTER REPORTS
- TEMOCAPRIAL TREATMENT AMELIORATES AUTOIMMUNE MYOCARDITIS IN RATS ASSOCIATED WITH ENHANCED CARDIOMYOCYTE THIOREDOXIN EXPRESSION
- Protection against Murine Coxsackievirus B3 Myocarditis by T Cell Vaccination
- OJ-052 Post-Myocarditic G-CSF Therapy Improves the Severity of the Disease in Experimental Autoimmune Myocarditis in Rats(Myocarditis, basic/clinical(M),Oral Presentation(Japanese),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- PE-320 Swimming Reduced the Severity of Atherosclerosis in Apolipoprotein E-deficient Mice(Atherosclerosis, Basic 5 (IHD) : PE55)(Poster Session (English))
- OE-113 Cardioprotective effects of MCI-186, a novel free radical scavenger, on acute autoimmune myocarditis(Heart Failure, Basic 1 (M) : OE13)(Oral Presentation (English))
- Beneficial Effects of Low-Dose Benidipine in Acute Autoimmune Myocarditis : Suppressive Effects on Inflammatory Cytokines and Inducible Nitric Oxide Synthase
- Immunoglobulin Treatment Suppresses Atherosclerosis in Apolipoprotein E Knockout Mice via the Fc Portion
- Cardioprotective Effects of Carvedilol on Acute Autoimmune Myocarditis : Anti-Inflammatory Effects Associated with Antioxidant Property
- Fc receptor-mediated inhibitory effect of immunoglobulin therapyupon autoimmune giant cell myocarditis
- Upregulation of redox-regulating protein, thioredoxin, in endomyocardial biopsy samples of patients with inflammatory cardiamyopathy
- Overexpression of thioredoxin in transgenic mice attenuates adriamycin-induced cardiomyopathy
- Immunoglobulin Therapy Improved Left Ventricular Function in Fulminant Myocarditis by the Reduction of Interleukin-6(Myocarditis, Basic/Clinical 1 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Disappearence of Ventricular Tachyarrhythmas Is a Good Prognostic Marker in Immunoglobulin Therapy for Patients with Fulminant Myocarditis
- Treatment of inflammatory cardiomyopathy with immunoglobulin ameriorates ventricular function with suppression of cytokines and oxidative stress
- OJ-390 Noninvasive Diagnosis of Acute Coronary Syndrome by Echocardiographic Detection of Postischemic Regional Left Ventricular Delayed Relaxation Using Color Kinesis(Echo/Doppler 13 (I) : OJ47)(Oral Presentation (Japanese))
- The Protection of Coenzyme Q_ against Experimental Viral Myocarditis in Mice : THE 8TH CONFERENCE ON PRVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
- 5)SIGNIFICANCE OF SERIAL CHANGES OF SERUM CPK AND MYOCARDIAL CALCIUM CONTENT IN EXPERIMENTAL VIRAL MYOCARDITIS IN MICE : THE 7th CONFERENCE ON CARDIOMYOPATHY
- COMPARISON OF CORONARY ARTERIOGRAPHIC FINDINGS DURING ATTACK BETWEEN ANGINA PECTORIS WITH ST ELEVATION AND ANGINA PECTORIS WITH ST DEPRESSION : Ischemic Heart disease : Ist Auditorium : Proceedings of the 43rd Annual Meeting of the Japanese Circulation So
- -3-CORONARY ARTERIAL SPASM AS A CAUSE OF EXERTIONAL ANGINA PECTORIS : Ischemic Heart Disease : PROCEEDINGS OF THE 42nd ANNUAL MEETING OF THE JAPANESE CIRCULATION SOCIETY
- Difference in Thioredoxin Expression in Viral Myocarditis in Inbred Strains of Mice
- Serum Thioredoxin (TRX) Levels in Patients With Heart Failure
- ELECTROCARDIOGRAPHIC FINDINGS OF ENCEPHALOMYOCARDITIS VIRAL MYOCARDITIS IN MICE : LOW VOLTAGE OF QRS COMPLEX IN SUBACUTE STAGE AND ARRHYTHMIAS IN CHRONIC STAGE : PROCEEDINGS OF THE 47th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY : Cardi
- PE-366 Pioglitazone Ameliorates Atherosclerosis in Apolipoprotein E Deficient Mice by Modulating the Balance of Effector and Regulatory T Cells(PE062,Atherosclerosis (Clinical/Treatment) (IHD),Poster Session (English),The 73rd Annual Scientific Meeting of
- DIAGNOSIS OF EPSTEIN-BARR VIRUS LYMPHOMA AFTER LIVER TRANSPLANTATION
- TNF-α regulates IL-4-induced FcεRII/CD23 gene expression and soluble FcεRII release by human monocytes
- Effects of Transdermal and Oral Estrogen Supplementation on Endothelial Function, Inflammation, and Cellular Redox State
- PJ-626 Cardiac Function Fluctuates During Exacerbation and Remission in Young Adult Patients with Chronic Fatigue Syndrome and "Small Heart"(Cardiac function, basic/clinical(04)(M),Poster Session(Japanese),The 72nd Annual Scientific Meeting of the Japanes
- Exhaustion of Vitamin E by Smoking in Young Women (Smoking 1 (H), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Evaluation of Arteriolar Hyalinosis of the Skin of Patients With Chronic Congestive Heart Failure
- PE-162 Serum Thioredoxin Concentrations and Cutaneous Arteriolar Hyalinosis with Thioredoxin Expression are Increased in Patients with Heart Failure(Heart Failure, Clinical 4 (M) : PE28)(Poster Session (English))
- FAMILIAL CONGESTIVE CARDIOMYOPATHY WITH POSITIVE RHEUMATOID FACTOR : REPORT OF ONE FAMILY.
- IDIOPATHIC CARDIOMYOPATHY AND HL-A : Cardiomyopathies, Kawasaki Disease : PROCEEDINGS OF THE 44th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- Successful Immunoglobulin Treatment for Fulminant Myocarditis and Serial Analysis of Serum Thioredoxin : A Case Report
- Increased arteriolar hyalinosis and thioredoxin expression of skin in patients with chronic heart failure
- 17)SIGNIFICANCE OF HLA ANALYSIS AND PENETRANCE OF ASH IN FAMILIAL CARDIOMYOPATHY WITH COEXISTING HYPERTROPHIC AND DILATED-LIKE TYPES IN TWO FAMILIES : THE 8th CONFERENCE ON CARIDIOMYOPATHY
- Right Ventricular Aneurysms Complicating Encephalomyocarditis Virus Myocarditis in Mice : THE 7th CONFERENCE ON PREVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
- Electrocardiographic Findings in Experimental Murine Myocarditis : Arrhythmias in the Chronic Stage : THE 7th CONFERENCE ON PREVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
- AN ANIMAL MODEL OF CONGESTIVE (DILATED) CARDIOMYOPATHY : DILATATION AND HYPERTROPHY OF THE HEART IN THE CHRONIC STAGE IN DBA/2 MICE WITH MYOCARDITIS CAUSED BY ENCEPHALOMYOCARDITIS VIRUS : Cardiomyopathy (I) : 46th Annual Scientific Meeting, Japanese Circu
- 12) HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY IN THE ELDERLY
- 2) ELECTROCARDIOGRAPHIC FINDINGS IN EXPERIMENTAL MYOCARDITIS : a) ENCEPHALOMYOCARDITIS VIRUS MYOCARDITIS IN MICE b) COXSACKIE B_1 VIRUS MYOCARDITIS IN GOLDEN HAMSTERS
- A CASE OF MYOCARDITIS WITH IMMUNOLOGICAL IDENTIFICATION OF MYOCARDIAL AND PERIPHERAL LYMPHOCYTE SUBSETS
- Suppression of adult T cell leukemia-derived factor/human thioredoxin induction by FK506 and cyclosporin A: a new mechanism of immune modulation via redox control
- Significance of Pericardial Cytokines in Giant Cell Myocarditis in Rats : Pathological Comparison to Viral Myocarditis in Mice
- Strain Difference in Rats With Experimental Giant Cell Myocarditis
- Cutaneous Arteriolar Hyalinosis with Thioredoxin Expression Is Increased in Patients with Heart Failure
- Cutaneous Arteriolar Thioredoxin Expression in Patients With Heart Failure
- Lack of correlation between redox-substances (Glutathione and Adult T-cell leukemia derived factors) and X-ray or heat sensitivity in six human squamous cell carcinoma cell lines.
- Oxystress-induced Nuclear Translocation of Thioredoxin : Involvement in the Redox Regulation of Transcription Factors, NF-κB and AP-1
- 10) IMPROVED CINEANGIOGRAPHIC EVALUATION OF HYPERTROPHIC CARDIOMYOPATHY BY ANGLEDBIVENTRICULOGRAPHY
- MYOCARDIAL CONTRACTILE PROTEINS IN CARDIOMYOPATHY : A BIOPSY STUDY : Myocardial Disease (I) : FREE COMMUNICATIONS (I) : PROCEEDINGS OF THE 49th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- 26) ANALYSIS OF ARRHYTHMIAS BY 24-HOUR ELECTROCARDIOGRAPHIC MONITORING IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
- Mural Thrombi in Mice with Acute Viral Myocarditis : THE 9th CONFERENCE ON PREVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
- IMMUNOLOGICAL BACKGROUNDS IN PATIENTS WITH DILATED CARDIOMYOPATHY AND MYOCARDITIS : CLINICAL AND EXPERIMENTAL STUDIES : Myocardial Disease (I) : FREE COMMUNICATIONS (I) : PROCEEDINGS OF THE 49th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIET
- EFFECTS OF PREDNISOLONE ON EXPERIMENTAL VIRAL MYOCARDITIS IN MICE : Cardiomyopathy : II : 48 Annual Scientific Meeting, Japanese Circulation Society
- EFFECTS OF COENZYME Q_ ON EXPERIMENTAL VIRAL MYOCARDITIS IN MICE : PROCEEDINGS OF THE 47th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY : Cardiomyopathy
- 14) EFFECTS OF PREDNISOLONE ON EXPERIMENTAL MYOCARDITIS
- HLA-DR ANTIGEN LINKAGE IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY : Cardiomyopathy : FREE COMMUNICATIONS (Abstract) : 45 Annual Scientific Meeting, Japanese Circulation Society
- 1) SILENT MYOCARDITIS IN BALB/c-NU/NU MICE
- 1)SIGNIFICANCE OF T-AND B-LYMPHOCYTES IN EXPERIMENTAL VIRAL MYOCARDITIS IN MICE : THE 8th CONFERENCE ON CARIDIOMYOPATHY
- IMMUNOLOGICAL BEHAVIOR OF LYMPHOCYTES IN EXPERIMENTAL VIRAL MYOCARDITIS : SIGNIFICANCE OF T-LYMPHOCYTES IN THE SEVERITY OF MYOCARDITIS AND SILENT MYOCARDITIS IN BALB/c-NU/NU MICE : Myocardial Disease (I) : FREE COMMUNICATIONS (I) : PROCEEDINGS OF THE 49th
- IgA-specific Fc Receptor and Immunoglobulin Factor
- Serum Levels of Soluble CD23 in Patients with Bullous Pemphigoid
- Immunoglobulin Treatment Ameliorates Myocarditis Associated With Reduction of Neurohumoral Activity(Myocarditis, Basic/Clinical 1 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- OJ-147 Immunoglobulin Treatment Ameliorates Murine Myocarditis Associated with Reduction of Neurohumoral Activity and Improvement of Extracellular Matrix Change(OJ25,Myocarditis, Basic/ Clinical (M),Oral Presentation (Japanese),The 73rd Annual Scientific
- The in Vivo Cardiotoxic Effect of Eosinophilic Cationic Protein in an Animal Preparation : THE 10th CONFERENCE ON THE 10th CONFERENCE ON PREVENTION FOR RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE
- MURAL THROMBUS IN EXPERIMENTAL VIRAL MYOCARDITIS IN MICE : TIME OF APPEARANCE AND RELATIONSHIP BETWEEN THROMBOSIS AND CONGESTIVE HEART FAILURE : Myocardial Disease (I) : FREE COMMUNICATIONS (I) : PROCEEDINGS OF THE 49th ANNUAL SCIENTIFIC MEETING OF THE JA
- Serial Electrocardiographic Changes in Fulminant Myocarditis