JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 1985; 6:797-801
© 1985 by the American College of Cardiology Foundation
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hosenpud, J.
Right arrow Articles by Niles, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hosenpud, J.
Right arrow Articles by Niles, N.

Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone

JD Hosenpud, JH McAnulty, and NR Niles

Six patients with myocarditis documented by biopsy, after a baseline right heart catheterization and echocardiogram, underwent treatment with azathioprine and prednisone. After 3 months of treatment, biopsy, right heart catheterization and echocardiogram were repeated. In addition to the immunosuppressive therapy, most patients received additional conventional medications for heart failure between evaluation periods (mean number of cardiac drugs increased from 1.7 +/- 1.0 to 2.7 +/- 0.05, p = 0.041). Mean heart rate decreased (105 +/- 14 to 84 +/- 13 beats/min, p = 0.016), as did pulmonary wedge pressure (23 +/- 8 to 12 +/- 4 mm Hg, p = 0.012). There were no significant changes in cardiac index (3.1 +/- 0.8 to 2.9 +/- 1.0 liters/min), end-diastolic dimension (62 +/- 13 to 62 +/- 12 mm) or fractional shortening (11 +/- 6 to 12 +/- 3%) with treatment. Complications from immunosuppressive therapy included severe soft tissue infection, acute psychosis and adrenal insufficiency in one patient each. The benefits from prednisone and azathioprine in this group of patients have not been demonstrated. Although heart rate and pulmonary wedge pressure decreased, these changes could be ascribed to increases in the conventional therapy for heart failure. Finally, there is a high incidence of side effects from prednisone and azathioprine therapy. These findings suggest that this unproven therapy for myocarditis should be limited to experimental protocols.


This article has been cited by other articles:


Home page
 HeartHome page
K J Lee, B W McCrindle, D J Bohn, G J Wilson, G P Taylor, R M Freedom, J F Smallhorn, and L N Benson
Clinical outcomes of acute myocarditis in childhood
Heart, August 1, 1999; 82(2): 226 - 233.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Martin, K. Sarai, M. Schindler, A. v. d. Loo, M. Yoshitake, and F. Beyersdorf
MEDOS HIA-VAD Biventricular Assist Device for Bridge to Recovery in Fulminant Myocarditis
Ann. Thorac. Surg., April 1, 1997; 63(4): 1145 - 1146.
[Abstract] [Full Text]

Home page
 CirculationHome page
M. Kodama, S. Zhang, H. Hanawa, M. Saeki, T. Inomata, K. Suzuki, S. Koyama, and A. Shibata
Effects of 15-Deoxyspergualin on Experimental Autoimmune Giant Cell Myocarditis of the Rat
Circulation, February 15, 1995; 91(4): 1116 - 1122.
[Abstract] [Full Text]

Home page
 NEJMHome page
L. G. Lange and G. F. Schreiner
Immune Mechanisms of Cardiac Disease
N. Engl. J. Med., April 21, 1994; 330(16): 1129 - 1135.
[Full Text]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 1985 by the American College of Cardiology Foundation.