[Late results of immunosuppressive therapy in patients with heart failure and biopsy proven myocarditis].

Late results of 6-month immunosuppressive therapy (prednisone from 1.5 mg/kg b.w. and azathioprine 2 mg/kg b.w.) simultaneously performed with a conventional treatment were analyzed in 20 patients with heart failure of unknown origin and bioptic diagnosed myocarditis. Average patients' age was 33.8 +/- 10.7 years, mean disease duration--7.8 month, mean left ventricular ejection fraction--25.9 +/- 8.9%. Follow up period was at least 24 months in all patients. 1 patient died before the end of therapy. After 6-month immunosuppressive therapy improvement was stated in 10 patients (50%)--group A, stable disease course in 3 (15%)--group B and deterioration in remaining 6 (30%)--group C. After the next 18 month conventional therapy as many as in 8 of 10 group A patients deterioration was observed, further improvement (EF increase from 17% to 43%) in 1 female patient and a stable disease course in the another female. Of 3 group B patients in 1 further improvement was observed and a stable course in 2 remaining. Of 6 group C patients 4 died, 1 underwent cardiac transplantation, 1 female patient is still alive, but does not put herself to control examinations. Early improvement after 6-month immunosuppressive treatment does not prejudge the later prognosis.