Myocardial bioptic findings in correlation with TL-201 imaging and hemodynamic parameters in patients with latent cardiomyopathies suspected of having myocarditis.
Sixty-eight patients (24 males, 44 females, mean age 37.2 years) belonging to NYHA classes I and II were investigated. All patients had a nondilated ventricle as well as hemodynamic criteria of "latent cardiomyopathy." In 78% of the patients, a high susceptibility to infection, frequent angina, or possible myocarditis were found. In 75.5%, the mean pulmonary artery pressure was abnormal. T1-201 scintigraphy revealed perfusion defects in 78%. Dyskinesia or hypokinesia were found in 52%. The left ventricular ejection fraction was normal in 74%. On biopsy, pathologic findings were detected in 60.9% of patients with a high frequency of hypertrophy and fibrosis (50%). In two patients, lymphocytic infiltrates were found. Immunohistologically, deposits of complement, IgG, IgM, and gammaglobulin, mainly in the sarcolemma, could be identified in 19.1% of cases. The myocardium was normal in 39.1%; insufficient material was found in 5.9% of patients. Morphologic, scintigraphic, and hemodynamic findings could not be correlated but the combination of two pathologic parameters permitted diagnosis. Biopsy was the most effective diagnostic method in myocarditis.
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001794:Blood Pressure; D002908:Chronic Disease; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000276:immunology / Q000473:pathology*; D011651:Pulmonary Artery / Q000503:physiopathology; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013318:Stroke Volume; D013793:Thallium
D011868:Radioisotopes; D013793:Thallium