Yoshizawa Saeko, Sugiyama Kato Tomoko, Mancini Donna, C Marboe Charles
Department of Pathology & Cell Biology, Columbia University Medical Center and The New York Presbyterian Hospital, New York 10032, USA.
Int Heart J. 2013;54(3):146-8. doi: 10.1536/ihj.54.146.
Eosinophilic infiltration of the myocardium is occasionally observed as an incidental histological finding in endomyocardial biopsy specimens before heart transplantation (HTx) as well as in explanted heart obtained at the time of HTx. However, the indications for HTx in these patients have not yet been fully established. We investigated the pre-HTx characteristics of the recipients with myocardial eosinophilic infiltration in the explanted heart and diagnosed as hypersensitivity myocarditis (HSM) (21 among 761 recipients, 2.8%). Dobutamine, a common cause of HSM, was administered to 12 patients (57%). Ten patients (47.6%) were on milrinone and 4 (19.0%) were on ventricular assist devices. Post-transplant survival of HSM patients was comparable to that of patients transplanted for active myocarditis or other cause of heart failure. In conclusion, myocardial eosinophilic infiltration is associated with multiple medications in patients with advanced heart failure; however, it does not affect the post-transplant prognosis.
在心脏移植（HTx）前的心内膜心肌活检标本以及HTx时获取的移植心脏中，偶尔会观察到心肌嗜酸性粒细胞浸润，这是一种偶然的组织学发现。然而，这些患者进行HTx的指征尚未完全明确。我们研究了移植心脏中有心肌嗜酸性粒细胞浸润且被诊断为过敏性心肌炎（HSM）的受者（761名受者中有21名，占2.8%）在HTx前的特征。12名患者（57%）使用了多巴酚丁胺，这是HSM的常见病因。10名患者（47.6%）使用了米力农，4名患者（19.0%）使用了心室辅助装置。HSM患者移植后的生存率与因活动性心肌炎或其他心力衰竭原因接受移植的患者相当。总之，晚期心力衰竭患者的心肌嗜酸性粒细胞浸润与多种药物有关；然而，它并不影响移植后的预后。
