Immunohistological evidence for a chronic intramyocardial inflammatory process in dilated cardiomyopathy.

摘要: OBJECTIVE: To determine whether immunohistochemical analysis of cardiac biopsies from patients presenting clinically as dilated cardiomyopathy (DCM) show a chronic inflammatory process. DESIGN: Comparative case control study. SETTING: Tertiary referral centre. PATIENTS: Biopsies 170 with DCM and 85 other diseases. RESULTS: Nine had sufficient interstitial cells to be called borderline myocarditis on conventional histology, leaving 161 DCM. In 78 (48%) there were T lymphocytes in the myocardium. 48 (62%) these lymphocyte densities range 2-14 per high power field (HPF), equivalent 7-50 mm2 tissue. 43 (89%) endothelial immune activation was demonstrated by MHC expression. 30 cell counts 1.5-2.0 HPF, 80% also showed activation. Lymphocyte density correlated increased expression class I II antigens adhesion molecules ICAM, VCAM, ELAM, LFA-3, GMP140. all less than 1.0 HPF (less 2-5 tissue). CONCLUSIONS: Nearly half their biopsies. A autoimmune process is still active within myocardium significant percentage Immunohistochemical will enhance sensitivity biopsy essential for diagnosis myocarditis.