Kühl U, Noutsias M, Seeberg B, Schannwell M, Welp L B, Schultheiss H P
Medical Klinik für Kardiologie, Pulmonologie und Angiologie, Heinrich-Heine Universität Düsseldorf, Germany.
J Card Fail. 1994 Oct;1(1):13-25. doi: 10.1016/1071-9164(94)90004-3.
Dilated cardiomyopathy continues to be an etiologically unknown heart muscle disease. Recent clinical and experimental data have suggested a causal relation to viral myocarditis. The clinical diagnosis, however, is unspecific, and diagnostic yield of the histologic evaluation of endomyocardial biopsies by light microscopy according to the Dallas classification is poor. The authors analyzed the biopsy specimens of 120 patients with suspected dilated cardiomyopathy by immunohistologic methods to obtain a more sensitive and specific identification and quantification of infiltrating lymphocytes, indicating an activated immunologic process within the myocardium. Increased lymphocytic infiltrates and inflammatory endothelial activation were demonstrated in patients with clinically suspected dilated cardiomyopathy. These findings are associated with the often seen progression of ventricular dysfunction. Further studies are necessary to prove whether these immunohistologically positive patients will improve under immunosuppressive therapy.
扩张型心肌病仍然是一种病因不明的心肌疾病。最近的临床和实验数据表明它与病毒性心肌炎存在因果关系。然而，临床诊断并不具有特异性，根据达拉斯分类法通过光学显微镜对心内膜活检进行组织学评估的诊断阳性率较低。作者采用免疫组织学方法分析了120例疑似扩张型心肌病患者的活检标本，以更敏感、特异的方式识别和定量浸润淋巴细胞，提示心肌内存在激活的免疫过程。临床疑似扩张型心肌病患者表现出淋巴细胞浸润增加和炎症性内皮激活。这些发现与常见的心室功能障碍进展相关。有必要进一步研究以证实这些免疫组织学检查呈阳性的患者在免疫抑制治疗下是否会有所改善。
