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Detailed pathologic evaluation on endomyocardial biopsy provides long-term prognostic information in patients with acute myocarditis.
- Source :
-
Cardiovascular Pathology . May2014, Vol. 23 Issue 3, p139-144. 6p. - Publication Year :
- 2014
-
Abstract
- Abstract: Background: The long-term prognosis of biopsy-proven myocarditis is not well known. We hypothesized that a detailed pathological examination of an endomyocardial biopsy (EMB) would reveal prognostic information in patients with acute myocarditis. Methods: Fifty-four patients were diagnosed with acute myocarditis based on an EMB. Pathological diagnosis was categorized into lymphocytic dominant (29.6%), eosinophilic dominant (22.2%), and borderline myocarditis (48.1%). Masson’s trichrome staining and further immunohistochemical staining for CD3, CD20, CD68, HLA-DR, TLR4, TLR8, enteroviral VP1, and caspase-3 expression were performed. The clinical outcomes were defined as all-cause and cardiovascular (CV) death. Results: During the median 10.4 years of follow up (9.7±5.7 years), the overall all-cause mortality was 20.4% and the CV mortality was 14.8% in patients with acute myocarditis. Lymphocytic dominant myocarditis patients showed a poor clinical outcome when compared with eosinophilic dominant myocarditis patients for both all-cause (37.5% vs. 0%, p=0.015) and CV (31.2% vs. 0%, p=0.029) mortality. Among borderline myocarditis patients, the presence of fibrosis was linked with poor clinical outcomes in both all-cause (75.0% vs. 21.4%, p=0.045) and CV (100.0% vs. 25.0%, p=0.034) mortality. No significant associations between clinical outcome and all other immunohistochemical staining targets were observed. Conclusions: Detailed pathological evaluation on an EMB provides prognostic information in patients with acute myocarditis. EMB evaluation should be considered in patients with suspected myocarditis. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 10548807
- Volume :
- 23
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Cardiovascular Pathology
- Publication Type :
- Academic Journal
- Accession number :
- 95926974
- Full Text :
- https://doi.org/10.1016/j.carpath.2014.01.004