Myocarditis was diagnosed by endomyocardial biopsy in 34 patients with otherwise unexplained heart failure. On the basis of both clinical and histologic findings these patients were divided into three groups. Seven patients had acute myocarditis (mean age, 20 years; mean ejection fraction, 22 per cent) characterized by an interstitial inflammatory infiltrate and extensive, acute cell damage. Five of these patients died after a mean duration of illness of eight weeks. Eighteen patients had rapidly progressive myocarditis (mean age, 35 years; mean ejection fraction, 19 per cent) characterized by patchy acute and healing cell damage and fibrosis; 17 of them died after a mean duration of illness of 23 months. Nine patients had chronic myocarditis (mean age, 31 years; mean ejection fraction, 31 per cent) characterized by focal inflammation and cell damage. All nine were alive after a mean follow-up period of 39 months. In four of these nine, clinical and hemodynamic improvement occurred after one month of immunosuppressive therapy. Our study suggests that a clinically useful classification of myocarditis can be accomplished by endomyocardial biopsy.
This article has been cited by other articles:
Wu, E-T, Huang, S-C, Chen, Y-S, Wang, J-K, Wu, M-H, Ko, W-J
(2006). Children with fulminant myocarditis rescued with extracorporeal membrane oxygenation.. Heart
92: 1325-1326
[Full Text]
Grinda, J.-M., Chevalier, P., D'Attellis, N., Bricourt, M.-O., Berrebi, A., Guibourt, P., Fabiani, J.-N., Deloche, A.
(2004). Fulminant myocarditis in adults and children: bi-ventricular assist device for recovery. Eur. J. Cardiothorac. Surg.
26: 1169-1173
[Abstract][Full Text]
Laissy, J.-P., Messin, B., Varenne, O., Iung, B., Karila-Cohen, D., Schouman-Claeys, E., Steg, P. G.
(2002). MRI of Acute Myocarditis: A Comprehensive Approach Based on Various Imaging Sequences. Chest
122: 1638-1648
[Abstract][Full Text]
D'Ambrosio, A, Patti, G, Manzoli, A, Sinagra, G, Di Lenarda, A, Silvestri, F, Di Sciascio, G
(2001). The fate of acute myocarditis between spontaneous improvement and evolution to dilated cardiomyopathy: a review. Heart
85: 499-504
[Full Text]
Feldman, A. M., McNamara, D.
(2000). Myocarditis. NEJM
343: 1388-1398
[Full Text]
Felker, G. M., Boehmer, J. P., Hruban, R. H., Hutchins, G. M., Kasper, E. K., Baughman, K. L., Hare, J. M.
(2000). Echocardiographic findings in fulminant and acute myocarditis. J Am Coll Cardiol
36: 227-232
[Abstract][Full Text]
McCarthy, R. E., Boehmer, J. P., Hruban, R. H., Hutchins, G. M., Kasper, E. K., Hare, J. M., Baughman, K. L.
(2000). Long-Term Outcome of Fulminant Myocarditis as Compared with Acute (Nonfulminant) Myocarditis. NEJM
342: 690-695
[Abstract][Full Text]
Houel, R., Vermes, E., Tixier, D. B., Le Besnerais, P., Benhaiem-Sigaux, N., Loisance, D. Y.
(1999). Myocardial recovery after mechanical support for acute myocarditis: is sustained recovery predictable?. Ann. Thorac. Surg.
68: 2177-2180
[Abstract][Full Text]
Chen, Y.-S., Wang, M.-J., Chou, N.-K., Han, Y.-Y., Chiu, I.-S., Lin, F.-Y., Chu, S.-H., Ko, W.-J.
(1999). Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation. Ann. Thorac. Surg.
68: 2220-2224
[Abstract][Full Text]
Friedrich, M. G., Strohm, O., Schulz-Menger, J., Marciniak, H., Luft, F. C., Dietz, R.
(1998). Contrast Media–Enhanced Magnetic Resonance Imaging Visualizes Myocardial Changes in the Course of Viral Myocarditis. Circulation
97: 1802-1809
[Abstract][Full Text]
Shetty, A. K.
(1998). A Child with Chest Pain. CLIN PEDIATR
37: 317-319
Okabe, M., Fukuda, K., Arakawa, K., Kikuchi, M.
(1997). Chronic Variant of Myocarditis Associated With Hepatitis C Virus Infection. Circulation
96: 22-24
[Abstract][Full Text]
Bachmaier, K., Pummerer, C., Kozieradzki, I., Pfeffer, K., Mak, T. W., Neu, N., Penninger, J. M.
(1997). Low-Molecular-Weight Tumor Necrosis Factor Receptor p55 Controls Induction of Autoimmune Heart Disease. Circulation
95: 655-661
[Abstract][Full Text]
Bachmaier, K., Mair, J., Offner, F., Pummerer, C., Neu, N.
(1995). Serum Cardiac Troponin T and Creatine Kinase–MB Elevations in Murine Autoimmune Myocarditis. Circulation
92: 1927-1932
[Abstract][Full Text]
Kremastinos, D. Th., Tiniakos, G., Theodorakis, G. N., Katritsis, D. G., Toutouzas, P. K.
(1995). Myocarditis in ß-Thalassemia Major : A Cause of Heart Failure. Circulation
91: 66-71
[Abstract][Full Text]
Stratmann, H. G.
(1988). Acute Myocarditis Versus Myocardial Infarction: Evaluation and Management of the Young Patient with Prolonged Chest Pain Case Reports. ANGIOLOGY
39: 253-258
[Abstract]
Woolf, P. K., Chung, T.-S., Stewart, J., Lialios, M., Davidian, M., Gewitz, M. H.
(1987). Life-threatening Dysrhythmias in Varicella Myocarditis. CLIN PEDIATR
26: 480-482
[Abstract]
Previous
