Relation between histological findings on early repeat right ventricular biopsy and ventricular function in patients with myocarditis. Br Heart J 1988 Oct;60(4):332-7
Date
10/01/1988Pubmed ID
3190962Pubmed Central ID
PMC1216581DOI
10.1136/hrt.60.4.332Scopus ID
2-s2.0-0023740516 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
Histological findings on repeat endomyocardial biopsy and changes in left ventricular ejection fraction early during immunosuppressive treatment were studied in 20 patients with documented myocarditis. All patients presented with heart failure of less than six months' duration and a left ventricular ejection fraction of less than or equal to 0.40. Repeat biopsy and assessment of ventricular function were performed at a mean (SEM) of 79 (17) days after the initial biopsy. At repeat biopsy eight patients had evidence of ongoing myocarditis and 12 showed resolved myocarditis. In eight (66%) of the 12 patients with resolved myocarditis ventricular function had improved significantly. Left ventricular ejection fraction also improved significantly in four of eight patients during treatment despite ongoing myocardial inflammation. Regardless of the histological findings on repeat biopsy, early improvement in ejection fraction was associated with an excellent long term prognosis--that is 83% survived for at least three years. Histological resolution of myocarditis during immunosuppressive treatment is not a prerequisite for improvement in ventricular function; and changes in left ventricular ejection fraction during the first three months of treatment are predictive of clinical outcome.
Author List
Dec GW Jr, Fallon JT, Southern JF, Palacios IFMESH terms used to index this publication - Major topics in bold
AdultBiopsy
Cardiomyopathy, Dilated
Endocardium
Female
Follow-Up Studies
Humans
Immunosuppressive Agents
Male
Middle Aged
Myocarditis
Prognosis
Stroke Volume
