title: Transient ventricular wall thickening in acute myocarditis: a serial echocardiographic and histopathologic study.
abstract: The present study was designed to determine whether the wall thickening seen in acute myocarditis is caused by interstitial edema. The study group comprised 25 patients (idiopathic myocarditis, 17; eosinophilic myocarditis, 8) in whom acute myocarditis was diagnosed histologically and who underwent echocardiography and endomyocardial biopsy during both the acute and convalescent phases. The following echocardiographic parameters were measured: interventricular septum and left ventricular posterior wall thickness, left ventricular end-diastolic dimension, and left ventricular ejection fraction. Based on the myocardial biopsy specimens, the degree of interstitial edema was classified into 3 grades [(-), 1(+), 2(+)] and the transverse diameter of cardiac myocytes was measured using light microscopy. The thickness of both the interventricular septum and left ventricular wall decreased from 14.3+/-3.7 mm and 13.3+/-2.4 mm in the acute phase to 9.7+/-1.7 mm (p<0.001) and 10.2+/-1.7 mm (p<0.0001), respectively, in the convalescent phase. Edema was present in 22 patients (88.0%) in the acute phase, but in the convalescent phase, edema was present in only 7 patients (28.0%), indicating a significant reduction in the degree of edema (p<0.0001). Cardiac myocyte diameter did not differ significantly between the acute (13.6+/-1.1 microm) and convalescent (13.8+/-1.8 microm) phases.
authors.affiliation: Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: S
authors.initials: S
authors.lastname: Morimoto
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.forename: A
authors.initials: A
authors.lastname: Uemura
authors.forename: N
authors.initials: N
authors.lastname: Kubo
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: A
authors.initials: A
authors.lastname: Sugiura
authors.forename: T
authors.initials: T
authors.lastname: Itoh
authors.forename: H
authors.initials: H
authors.lastname: Hishida
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001706:Biopsy; D048429:Cell Size; D002648:Child; D004452:Echocardiography; D004489:Edema, Cardiac / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000473:pathology*; D009206:Myocardium / Q000473:pathology; D018709:Statistics, Nonparametric; D013997:Time Factors; D020257:Ventricular Remodeling