Level of left ventricular dysfunction in endomyocardial biopsy-proven myocarditis.

The level of myocardial functional impairment in the course of myocarditis still remains associated with controversial data. However, many investigators agree that there is a significant heart failure during myocarditis and a large number of studies suggest development of global chronic or acute heart failure. The objective of this study was to establish haemodynamic parameters as descriptors of the level of myocardial systolic and diastolic impairment. From 131 investigated patients, 95 were assigned to the study group and 36 to the control group. All patients underwent right and left heart catheterization. A group of patients underwent EMB (endomyocardial biopsy) of the right ventricle. According to the Dallas Criteria, patients were divided into three groups: active myocarditis with fibrosis, active myocarditis without fibrosis and borderline myocarditis. The following haemodynamic parameters were evaluated: left ventricle EF (ejection fraction), cardiac index and end diastolic pressure of the left ventricle. EF, which reflects left ventricular systolic impairment, showed a difference related to the control group, while there was no difference in cardiac index between the groups. Diastolic dysfunction (end diastolic pressure of the left ventricle) was noted in the group with active myocarditis, but not in the group with borderline myocarditis.