Presence of poorly stained myocytes in acute myocarditis predicts improvement in cardiac function.

Histological findings in the acute phase of myocarditis were evaluated as a prediction of hemodynamic state in the chronic phase in 20 patients with clinical and pathological diagnoses of myocarditis who were followed up with echocardiography for at least 1 year. Endomyocardial biopsy samples were obtained from the left ventricle within 1 year of the onset of symptoms. Azan-Mallory staining was performed on the myocytes, which were categorized as either well stained or poorly stained. The point counting method was used to determine the fraction of each type. The improvement in ejection fraction within 1 year correlated significantly with the fraction of poorly stained myocytes (r = 0.46, p < 0.05). The ejection fraction at biopsy was negatively correlated with the volume fraction of well stained myocytes (r = -0.64, p < 0.01). The staining condition of myocytes may be useful in predicting the hemodynamic recovery of patients with myocarditis.