title: Significance of transient left ventricular wall thickening in acute lymphocytic myocarditis.
abstract: Transient left ventricular (LV) wall thickening is observed in patients with acute lymphocytic myocarditis. The present study was undertaken to clarify the significance of transient LV wall thickening in patients with this disease. The subjects comprised 25 patients with acute lymphocytic myocarditis. Echocardiography was used to measure the thickness of the interventricular septum (IVS) and the LV posterior wall (PW) at four time points after myocarditis onset--namely, on days 1-3, 6-8, 13-15, and 28-30--to clarify the timing and frequency of wall thickening. The 25 patients were divided into a fulminant myocarditis group (n = 14) and a nonfulminant myocarditis group (n = 11), and the relationship between LV wall thickening and myocarditis severity was investigated. Left ventricular wall thickening was greatest on days 1-3 after myocarditis onset (IVS: 13.3 +/- 3.2 mm; PW: 12.1 +/- 2.6 mm), with this finding being noted in 14 of the 25 cases (56%). By days 6-8, the thickness of IVS had virtually normalized to 10.6 +/- 1.6 mm (P < 0.0001) and that of PW to 10.2 +/- 1.4 mm (P = 0.0006). The thickness of the IVS and PW on days 1-3 after myocarditis onset were 14.6 +/- 3.7 and 13.0 +/- 2.9 mm, respectively, in the fulminant group (P = 0.014), and 11.5 +/- 0.9 and 10.9 +/- 1.4 mm, respectively, in the nonfulminant group (P = 0.039). In lymphocytic myocarditis, LV wall thickening is greatest on days 1-3 after myocarditis onset and improves to near normal by days 6-8. Such transient LV wall thickening occurs in approximately 50% of cases. Left ventricular wall thickening was more marked in the fulminant compared with the nonfulminant group.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Morimoto
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kato
authors.forename: Akihisa
authors.initials: A
authors.lastname: Uemura
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ohtsuki
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Kato
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugiura
authors.forename: Kenji
authors.initials: K
authors.lastname: Miyagishima
authors.forename: Nami
authors.initials: N
authors.lastname: Mori
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yoda
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Mori
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwase
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D004489:Edema, Cardiac / Q000473:pathology; D005260:Female; D006346:Heart Septum / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D032383:Myocytes, Cardiac / Q000473:pathology; D013318:Stroke Volume; D013997:Time Factors; D018487:Ventricular Dysfunction, Left