[Dilated cardiomyopathy: sequela of viral myocarditis?]

The study was undertaken to examine 100 patients with dilated cardiomyopathy (DCM) and 62 with viral myocarditis (VM). Serological studies revealed that 60% of the VM patients and 25% of the DCM patients had diagnostically significant antibody titers to Coxsackie B virus. The patients from the two groups displayed NK cell deficiency, quantitative and functional suppressor defect, and severe derangements in the system of interferons. Unlike DCM patients, some VM patients showed greater quantities of cells having phenotype OKT 8. A follow-up demonstrated that 11% of the VM patients developed a symptom complex typical of DCM. Changes in immunological parameters appeared as smaller numbers of the cells with phenotype T 8 in the patients. Immunogenetic study revealed the genetic marker HLA-B12 common in VM and DCM. VM evolved into DCM in 75% of the VM patients who had antigen B12. Clinical, serological, and immunological studies enabled a risk group of patients with VM in whom the disease might develop to DCM to be detected.