{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:04:32Z","timestamp":1764785072996,"version":"build-2065373602"},"reference-count":75,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>In the course of the SARS-CoV-2 pandemic, vaccination safety and risk factors of SARS-CoV-2 mRNA-vaccines were under consideration after case reports of vaccine-related side effects, such as myocarditis, which were mostly described in young men. However, there is almost no data on the risk and safety of vaccination, especially in patients who are already diagnosed with acute\/chronic (autoimmune) myocarditis from other causes, such as viral infections, or as a side effect of medication and treatment. Thus, the risk and safety of these vaccines, in combination with other therapies that could induce myocarditis (e.g., immune checkpoint inhibitor (ICI) therapy), are still poorly assessable. Therefore, vaccine safety, with respect to worsening myocardial inflammation and myocardial function, was studied in an animal model of experimentally induced autoimmune myocarditis. Furthermore, it is known that ICI treatment (e.g., antibodies (abs) against PD-1, PD-L1, and CTLA-4, or a combination of those) plays an important role in the treatment of oncological patients. However, it is also known that treatment with ICIs can induce severe, life-threatening myocarditis in some patients. Genetically different A\/J (most susceptible strain) and C57BL\/6 (resistant strain) mice, with diverse susceptibilities for induction of experimental autoimmune myocarditis (EAM) at various age and gender, were vaccinated twice with SARS-CoV-2 mRNA-vaccine. In an additional A\/J group, an autoimmune myocarditis was induced. In regard to ICIs, we tested the safety of SARS-CoV-2 vaccination in PD-1\u2212\/\u2212 mice alone, and in combination with CTLA-4 abs. Our results showed no adverse effects related to inflammation and heart function after mRNA-vaccination, independent of age, gender, and in different mouse strains susceptible for induction of experimental myocarditis. Moreover, there was no worsening effect on inflammation and cardiac function when EAM in susceptible mice was induced. However, in the experiments with vaccination and ICI treatment, we observed, in some mice, low elevation of cardiac troponins in sera, and low scores of myocardial inflammation. In sum, mRNA-vaccines are safe in a model of experimentally induced autoimmune myocarditis, but patients undergoing ICI therapy should be closely monitored when vaccinated.<\/jats:p>","DOI":"10.3390\/ijms24055011","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T03:49:08Z","timestamp":1678074548000},"page":"5011","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Effect of SARS-CoV-2 mRNA-Vaccine on the Induction of Myocarditis in Different Murine Animal Models"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9405-8286","authenticated-orcid":false,"given":"Vanessa A.","family":"Zirkenbach","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca M.","family":"Ignatz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate","family":"\u00d6ttl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeynep","family":"Cehreli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera","family":"Stroikova","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mansur","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz H.","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg\/Mannheim, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Preusch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg\/Mannheim, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg\/Mannheim, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-0836","authenticated-orcid":false,"given":"Ziya","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Heidelberg, 69120 Heidelberg, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg\/Mannheim, University of Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus\u2014Infected Pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5603\/CJ.a2020.0055","article-title":"COVID-19 challenge for modern medicine","volume":"27","author":"Dzieciatkowski","year":"2020","journal-title":"Cardiol. J."},{"key":"ref_4","first-page":"153","article-title":"Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period","volume":"28","author":"Ozma","year":"2020","journal-title":"Infez. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2001383","DOI":"10.2807\/1560-7917.ES.2020.25.31.2001383","article-title":"Age-specific SARS-CoV-2 infection fatality ratio and associated risk factors, Italy, February to April 2020","volume":"25","author":"Poletti","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1056\/NEJMoa2110345","article-title":"Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months","volume":"385","author":"Thomas","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1038\/s41586-020-2622-0","article-title":"SARS-CoV-2 mRNA vaccine design enabled by prototype pathogen preparedness","volume":"586","author":"Corbett","year":"2020","journal-title":"Nature"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/s41586-020-2639-4","article-title":"Phase I\/II study of COVID-19 RNA vaccine BNT162b1 in adults","volume":"586","author":"Mulligan","year":"2020","journal-title":"Nature"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1001\/jama.2021.15125","article-title":"Comparison of SARS-CoV-2 Antibody Response Following Vaccination With BNT162b2 and mRNA-1273","volume":"326","author":"Steensels","year":"2021","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1161\/CIRCULATIONAHA.121.055913","article-title":"Myocarditis After BNT162b2 and mRNA-1273 Vaccination","volume":"144","author":"Larson","year":"2021","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1001\/jama.2021.24110","article-title":"Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021","volume":"327","author":"Oster","year":"2022","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1038\/s41591-021-01630-0","article-title":"Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection","volume":"28","author":"Patone","year":"2021","journal-title":"Nat. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1161\/CIRCULATIONAHA.121.056135","article-title":"Myocarditis With COVID-19 mRNA Vaccines","volume":"144","author":"Bozkurt","year":"2021","journal-title":"Circulation"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1056\/NEJMoa2109730","article-title":"Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel","volume":"385","author":"Mevorach","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1056\/NEJMoa2110475","article-title":"Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting","volume":"385","author":"Barda","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1001\/jamacardio.2022.0583","article-title":"SARS-CoV-2 Vaccination and Myocarditis in a Nordic Cohort Study of 23 Million Residents","volume":"7","author":"Karlstad","year":"2022","journal-title":"JAMA Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Hajjo, R., Sabbah, D.A., Bardaweel, S.K., and Tropsha, A. (2021). Shedding the Light on Post-Vaccine Myocarditis and Pericarditis in COVID-19 and Non-COVID-19 Vaccine Recipients. Vaccines, 9.","DOI":"10.3390\/vaccines9101186"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"102898","DOI":"10.1016\/j.jaut.2022.102898","article-title":"Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review","volume":"132","author":"Rojas","year":"2022","journal-title":"J. Autoimmun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"108480","DOI":"10.1016\/j.clim.2020.108480","article-title":"Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases","volume":"217","author":"Vojdani","year":"2020","journal-title":"Clin. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.vaccine.2021.11.093","article-title":"Post RNA-based COVID vaccines myocarditis: Proposed mechanisms","volume":"40","author":"Kadkhoda","year":"2022","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3790","DOI":"10.1016\/j.vaccine.2021.05.087","article-title":"Myocarditis following COVID-19 mRNA vaccination","volume":"39","author":"Roguin","year":"2021","journal-title":"Vaccine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107970","DOI":"10.1016\/j.intimp.2021.107970","article-title":"Autoimmune phenomena following SARS-CoV-2 vaccination","volume":"99","author":"Ishay","year":"2021","journal-title":"Int. Immunopharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s12020-022-03118-4","article-title":"Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: From etiopathogenesis to clinical management","volume":"78","author":"Caron","year":"2022","journal-title":"Endocrine"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kang, D.-H., Na, J.-Y., Yang, J.-H., Moon, S.-H., Kim, S.-H., Jung, J.-J., Cha, H.-J., Ahn, J.-H., Park, Y.-W., and Cho, S.-Y. (2022). Fulminant Giant Cell Myocarditis following Heterologous Vaccination of ChAdOx1 nCoV-19 and Pfizer-BioNTech COVID-19. Medicina, 58.","DOI":"10.3390\/medicina58030449"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/01.CIR.93.5.841","article-title":"Report of the 1995 World Health Organization\/International Society and Federation of Cardiology Task Force on the Definition and Classification of Cardiomyopathies","volume":"93","author":"Richardson","year":"1996","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"JCS Joint Working Group (2011). Guidelines for Diagnosis and Treatment of Myocarditis (JCS 2009): Digest version. Circ. J., 75, 734\u2013743.","DOI":"10.1253\/circj.CJ-88-0008"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2636","DOI":"10.1093\/eurheartj\/eht210","article-title":"Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases","volume":"34","author":"Caforio","year":"2013","journal-title":"Eur. Heart J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s00059-005-2730-5","article-title":"Inflammatory Dilated Cardiomyopathy (DCMI)","volume":"30","author":"Maisch","year":"2005","journal-title":"Herz"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.jaut.2009.07.009","article-title":"Autoimmune myocarditis: Past, present and future","volume":"33","author":"Leuschner","year":"2009","journal-title":"J. Autoimmun."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1161\/CIRCULATIONAHA.106.635664","article-title":"Cardiac Troponin I but Not Cardiac Troponin T Induces Severe Autoimmune Inflammation in the Myocardium","volume":"114","author":"Andrassy","year":"2006","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1161\/CIRCULATIONAHA.108.788711","article-title":"Identification of Cardiac Troponin I Sequence Motifs Leading to Heart Failure by Induction of Myocardial Inflammation and Fibrosis","volume":"118","author":"Kaya","year":"2008","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1161\/CIRCRESAHA.111.245563","article-title":"Role of the Cholinergic Antiinflammatory Pathway in Murine Autoimmune Myocarditis","volume":"109","author":"Leib","year":"2011","journal-title":"Circ. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.cardfail.2019.06.003","article-title":"FN14 Signaling Plays a Pathogenic Role in a Mouse Model of Experimental Autoimmune Myocarditis","volume":"25","author":"Fischer","year":"2019","journal-title":"J. Card. Fail."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1161\/CIRCULATIONAHA.119.043171","article-title":"Heart-Specific Immune Responses in an Animal Model of Autoimmune-Related Myocarditis Mitigated by an Immunoproteasome Inhibitor and Genetic Ablation","volume":"141","author":"Bockstahler","year":"2020","journal-title":"Circulation"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/0167-5273(96)02595-8","article-title":"Autoimmune myocarditis","volume":"54","author":"Rose","year":"1996","journal-title":"Int. J. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3630","DOI":"10.4049\/jimmunol.139.11.3630","article-title":"Cardiac myosin induces myocarditis in genetically predisposed mice","volume":"139","author":"Neu","year":"1987","journal-title":"J. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1038\/s41586-022-05432-3","article-title":"T cells specific for \u03b1-myosin drive immunotherapy-related myocarditis","volume":"611","author":"Axelrod","year":"2022","journal-title":"Nature"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3400","DOI":"10.1161\/CIRCULATIONAHA.105.572396","article-title":"Critical Role for Monocyte Chemoattractant Protein-1 and Macrophage Inflammatory Protein-1\u03b1 in Induction of Experimental Autoimmune Myocarditis and Effective Anti\u2013Monocyte Chemoattractant Protein-1 Gene Therapy","volume":"112","author":"Ottl","year":"2005","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1200\/JCO.2014.59.4358","article-title":"Immune Checkpoint Blockade in Cancer Therapy","volume":"33","author":"Postow","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1634\/theoncologist.2018-0130","article-title":"Immune Checkpoint Inhibitor-Associated Myocarditis","volume":"23","author":"Ganatra","year":"2018","journal-title":"Oncologist"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3127","DOI":"10.1182\/blood-2005-06-2298","article-title":"Human CTLA4 knock-in mice unravel the quantitative link between tumor immunity and autoimmunity induced by anti\u2013CTLA-4 antibodies","volume":"106","author":"Lute","year":"2005","journal-title":"Blood"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1158\/2159-8290.CD-20-0856","article-title":"A Genetic Mouse Model Recapitulates Immune Checkpoint Inhibitor\u2013Associated Myocarditis and Supports a Mechanism-Based Therapeutic Intervention","volume":"11","author":"Wei","year":"2021","journal-title":"Cancer Discov."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1126\/science.291.5502.319","article-title":"Autoimmune Dilated Cardiomyopathy in PD-1 Receptor-Deficient Mice","volume":"291","author":"Nishimura","year":"2001","journal-title":"Science"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1038\/nm955","article-title":"Autoantibodies against cardiac troponin I are responsible for dilated cardiomyopathy in PD-1-deficient mice","volume":"9","author":"Okazaki","year":"2003","journal-title":"Nat. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Vogel, A.B., Kanevsky, I., Che, Y., Swanson, K.A., Muik, A., Vormehr, M., Kranz, L.M., Walzer, K.C., Hein, S., and G\u00fcler, A. (2020). A prefusion SARS-CoV-2 spike RNA vaccine is highly immunogenic and prevents lung infection in non-human primates. bioRxiv.","DOI":"10.1101\/2020.09.08.280818"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S0140-6736(20)31604-4","article-title":"Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: A preliminary report of a phase 1\/2, single-blind, randomised controlled trial","volume":"396","author":"Folegatti","year":"2020","journal-title":"Lancet"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1056\/NEJMoa2101544","article-title":"Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19","volume":"384","author":"Sadoff","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1038\/nrd4278","article-title":"mRNA-based therapeutics\u2014Developing a new class of drugs","volume":"13","author":"Sahin","year":"2014","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1586\/14760584.2015.986104","article-title":"Lipid-based mRNA vaccine delivery systems","volume":"14","author":"Midoux","year":"2015","journal-title":"Expert Rev. Vaccines"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"319","DOI":"10.4155\/tde-2016-0006","article-title":"mRNA vaccine delivery using lipid nanoparticles","volume":"7","author":"Reichmuth","year":"2016","journal-title":"Ther. Deliv."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/nrd.2017.243","article-title":"mRNA vaccines\u2014A new era in vaccinology","volume":"17","author":"Pardi","year":"2018","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/acem.14322","article-title":"Myopericarditis in a previously healthy adolescent male following COVID-19 vaccination: A case report","volume":"28","author":"McLean","year":"2021","journal-title":"Acad. Emerg. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e2021052478","DOI":"10.1542\/peds.2021-052478","article-title":"Symptomatic Acute Myocarditis in 7 Adolescents After Pfizer-BioNTech COVID-19 Vaccination","volume":"148","author":"Marshall","year":"2021","journal-title":"Pediatrics"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"101077","DOI":"10.1016\/j.cpcardiol.2021.101077","article-title":"Clinical Cardiovascular Adverse Events Reported Post-COVID-19 Vaccination: Are They a Real Risk?","volume":"47","author":"Hana","year":"2021","journal-title":"Curr. Probl. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s40119-021-00248-0","article-title":"Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview","volume":"11","author":"Shiravi","year":"2021","journal-title":"Cardiol. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4398","DOI":"10.1016\/j.vaccine.2015.07.035","article-title":"Safety monitoring in the Vaccine Adverse Event Reporting System (VAERS)","volume":"33","author":"Shimabukuro","year":"2015","journal-title":"Vaccine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1136\/heartjnl-2013-304449","article-title":"The effects of gender and age on occurrence of clinically suspected myocarditis in adulthood","volume":"99","author":"Rautava","year":"2013","journal-title":"Heart"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.amjcard.2021.03.019","article-title":"Trends in Acute Myocarditis Related Pediatric Hospitalizations in the United States, 2007\u20132016","volume":"149","author":"Vasudeva","year":"2021","journal-title":"Am. J. Cardiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e026873","DOI":"10.1161\/JAHA.122.026873","article-title":"Vaccine-Triggered Acute Autoimmune Myocarditis: Defining, Detecting, and Managing an Apparently Novel Condition","volume":"11","author":"Mohiddin","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e026097","DOI":"10.1161\/JAHA.122.026097","article-title":"Myocarditis After COVID-19 Vaccination in Pediatrics: A Proposed Pathway for Triage and Treatment","volume":"11","author":"Sandeep","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"977","DOI":"10.15585\/mmwr.mm7027e2","article-title":"Use of mRNA COVID-19 Vaccine After Reports of Myocarditis Among Vaccine Recipients: Update from the Advisory Committee on Immunization Practices\u2014United States, June 2021","volume":"70","author":"Gargano","year":"2021","journal-title":"MMWR. Morb. Mortal. Wkly. Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1136\/heartjnl-2020-318083","article-title":"Cardiotoxicities of novel cancer immunotherapies","volume":"107","author":"Rothberg","year":"2021","journal-title":"Heart"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ijcard.2021.09.041","article-title":"Cardiotoxicity in cancer immune-checkpoint therapy: Mechanisms, clinical evidence, and management strategies","volume":"344","author":"Sun","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"102282","DOI":"10.1016\/j.ctrv.2021.102282","article-title":"Pathophysiology, diagnosis and management of cardiac toxicity induced by immune checkpoint inhibitors and BRAF and MEK inhibitors","volume":"100","author":"Arangalage","year":"2021","journal-title":"Cancer Treat. Rev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"3477","DOI":"10.2217\/fon-2021-0288","article-title":"Indications for and contraindications of immune checkpoint inhibitors in cancer patients with COVID-19 vaccination","volume":"17","author":"Luo","year":"2021","journal-title":"Future Oncol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S1470-2045(21)00155-8","article-title":"Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors","volume":"22","author":"Waissengrin","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.cca.2010.12.034","article-title":"Multicenter analytical evaluation of a high-sensitivity troponin T assay","volume":"412","author":"Saenger","year":"2011","journal-title":"Clin. Chim. Acta"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1016\/S0735-1097(00)00939-6","article-title":"Nasal administration of cardiac myosin suppresses autoimmune myocarditis in mice","volume":"36","author":"Wang","year":"2000","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1038\/90686","article-title":"Contribution of the innate immune system to autoimmune myocarditis: A role for complement","volume":"2","author":"Kaya","year":"2001","journal-title":"Nat. Immunol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"E155","DOI":"10.1073\/pnas.1522288113","article-title":"Critical role of RAGE and HMGB1 in inflammatory heart disease","volume":"113","author":"Bangert","year":"2016","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/cvr\/cvr063","article-title":"Comparison of IL-10 and MCP-1-7ND gene transfer with AAV9 vectors for protection from murine autoimmune myocarditis","volume":"91","author":"Kaya","year":"2011","journal-title":"Cardiovasc. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1258\/la.2007.06001e","article-title":"Echocardiographic assessment of global left ventricular function in mice","volume":"43","author":"Stypmann","year":"2009","journal-title":"Lab. Anim."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1093\/eurheartj\/ehn268","article-title":"Absence of auto-antibodies against cardiac troponin I predicts improvement of left ventricular function after acute myocardial infarction","volume":"29","author":"Leuschner","year":"2008","journal-title":"Eur. 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