Author + information
- Received February 28, 1983
- Revision received July 18, 1983
- Accepted July 20, 1983
- Published online January 1, 1984.
- Chi-Sung Zee-Cheng, MD,
- Cheng Chang Tsai, MD,
- Diane C. Palmer, MD,
- John E. Codd, MD,
- D. Glenn Pennington, MD, FACC and
- George A. Williams, MD, FACC*
- ↵*Address for reprints: George A. Williams, MD, St. Louis University Hospital, 1325 S. Grand Boulevard, St. Louis, Missouri 63104.
Thirty-five patients with unexplained congestive heart failure were evaluated with endomyocardial biopsy. Utilizing microscopic, ultrastructural and immunofluores-cent studies, samples were classified as exhibiting either no inflammation (cardiomyopathy) or active lymphocytic myocarditis, grade I to IV. Twenty-two (63%) of the patients had inflammatory changes. Of these 22 patients, 18 had low grade I or II inflammation, 7 were treated with immunosuppressive agents with improvement in 5 and stabilization in 1. One patient died of progressive congestive heart failure. Three of four patients with high grade III or IV myocarditis died after a fulminant course. The results suggest that inflammatory myocarditis may be more common than previously suspected and add evidence that there may be ongoing inflammation in many cases of congestive cardiomyopathy.
- Received February 28, 1983.
- Revision received July 18, 1983.
- Accepted July 20, 1983.
- American College of Cardiology Foundation