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Immunosuppressive therapy in inflammatory myocarditis: long-term follow-up
K K Talwar1, K C Goswami, P Chopra
1Department of Cardiology and Pathology, All India Institute of Medical Sciences, New Delhi.
International Journal of Cardiology
|February 1, 1992
Summary
Immunosuppressive therapy, including azathioprine and prednisolone, showed promise for patients with inflammatory myocarditis. While some patients improved significantly, careful management is crucial, as therapy withdrawal led to adverse outcomes.
Area of Science:
- Cardiology
- Immunology
Background:
- Myocarditis is an inflammatory condition of the heart muscle.
- Severe myocarditis can lead to significant heart dysfunction and mortality.
Purpose of the Study:
- To evaluate the efficacy of immunosuppressive therapy in patients with biopsy-proven inflammatory myocarditis.
- To assess clinical and hemodynamic outcomes in patients treated with azathioprine and prednisolone.
Main Methods:
- Prospective evaluation of 16 patients with endomyocardial biopsy-proven myocarditis.
- Treatment involved immunosuppressive agents (azathioprine, prednisolone) alongside standard care.
- Serial hemodynamic assessments and myocardial morphology evaluations were performed.
Main Results:
- Twelve of 16 patients showed improvement; 4 deteriorated, with 2 deaths within 2 months.
- Therapy withdrawal in improved patients led to worsening and death in 3 cases.
- Significant improvements observed in cardiothoracic ratio, pulmonary artery pressures, and left ventricular ejection fraction.
- Long-term follow-up (1-4 years) showed sustained improvement in remaining patients.
Conclusions:
- Immunosuppressive therapy may be beneficial for patients with inflammatory myocarditis.
- Careful monitoring and management are essential due to potential adverse events upon therapy cessation.
- Further controlled studies are warranted to confirm these findings.
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