Myocarditis as a precipitating factor for heart failure: evaluation and 1-year follow-up using cardiovascular magnetic resonance and endomyocardial biopsy.

摘要: Eighty-five patients with suspected myocarditis and 20 controls were evaluated. Seventy-one positive CMR referred for endomyocardial biopsy re-evaluation after 1 year. Cardiovascular magnetic resonance was performed using STIR T2-weighted (T2W), early T1-weighted (EGE), late gadolinium-enhanced (LGE) images. Immunohistological polymerase chain reaction (PCR) analysis of myocardial specimens employed. In myocarditis, T2 EGE increased compared (2.6+0.9 vs. 1.57+0.13, P , 0.001 7.9+5.5 3.59+0.08, 0.001, respectively). Late gadolinium enhancement found in all myo- carditis patients. Endomyocardial 50 71 showed immu- nohistology 48% presence infectious genomes 80% (mainly Chlamydia, Herpes, Parvovirus B19). Left ventricular ejection fraction (LVEF) significantly decreased (47.7+19.2 64+0.2, 0.001). After year, normalization EGE, LGE. 36.5% patients, remained stable 56.5% 7% whom persistence the initial infective agents. A negative correlation identified between LGE, LVEF. Patients biopsies had lower LVEFs. Conclusion a Greek population Chlamydia viruses common finding. res- onance PCR proved useful detection myocarditis; LGE best devel- opment heart failure. Persistence initially detected agents who deteriorated further.