title: Improvement of left ventricular systolic function in inflammatory cardiomyopathy: What plays a role?
abstract: OBJECTIVE
  To compare the differences between patients with inflammatory cardiomyopathy (ICM) with and without improvement in left ventricular (LV) systolic function and to identify the relevant predictors of LV improvement.
  
  
  METHODS
  The study included 63 patients with biopsy-proven ICM and heart failure symptoms of at least NYHA II, symptom duration ≤ 6 months, LV ejection fraction (LVEF) ≤ 40% assessed by echocardiography and presence of >14 mononuclear leukocytes (LCA+ cells)/mm2in biopsy samples. Patients were evaluated at baseline and after 6 months.
  
  
  RESULTS
  In the group with LVEF improvement of ≥ 10% (I+ group, n = 41), LVEF increased from 24 ± 7% to 47 ± 8% (P < 0.001). In 22 patients (group I-), there was no or minimal LVEF increase (< 10%). In the I+ group, there were more LCA+ cells/mm2at baseline (25.1 ± 16.5 vs. 18.5 ± 4.4 cells/mm2; P = 0.032) and a more significant decrease in LCA+ cells in the follow-up (reduction of 13.6 ± 14.3 cells/mm2vs. 5.0 ± 7.7 cells/mm2in the I- group; P = 0.009). The univariate logistic regression showed a possible association of number of LCA+ cells, LV end-diastolic diameter and N-terminal fragment of pro-brain natriuretic peptide (NTproBNP) value with LVEF improvement. In the multivariate analysis, only NTproBNP at diagnosis was confirmed as an independent predictor of LVEF improvement (OR=1.2; 1.003 to 1.394; P = 0.046).
  
  
  CONCLUSIONS
  The LV systolic function improvement was observed in 65% of the patients. In these patients, the number of inflammatory cells at baseline was higher and decreased more but the higher baseline NTproBNP value was the only independent predictor of LVEF improvement.
authors.affiliation: Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Krejci
authors.affiliation: Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Hude
authors.affiliation: Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Ozabalova
authors.affiliation: Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Dalibor
authors.initials: D
authors.lastname: Mlejnek
authors.affiliation: First Department of Pathological Anatomy, St. Anne's University Hospital in Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Vita
authors.initials: V
authors.lastname: Zampachova
authors.affiliation: First Department of Pathological Anatomy, St. Anne's University Hospital in Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Iva
authors.initials: I
authors.lastname: Svobodova
authors.affiliation: Department of Internal Medicine and Cardiology, University Hospital Brno, Czech Republic.
authors.forename: Radka
authors.initials: R
authors.lastname: Stepanova
authors.affiliation: Department of Cardiovascular Diseases, St. Anne's University Hospital Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D020127:Recovery of Function; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: NTproBNP; echocardiography; endomyocardial biopsy; inflammatory cardiomyopathy; right heart catheterization.