INTERFERON AND THYMIC HORMONES IN THE THERAPY OF HUMAN MYOCARDITIS AND IDIOPATHIC DILATED CARDIOMYOPATHY

It is becoming increasingly apparent that idiopathic dilated cardiomyo pathy (IDC) probably results from an acute viral myocarditis. One reas onable hypothesis is that persistent viral infection causes myocardial destruction leading to left ventricular dilatation and heart failure. The aim of this study was to evaluate the efficacy of interferon-alph a (IFN) and thymomodulin in the treatment of idiopathic myocarditis an d IDC. Clinical, immunological, haemodynamic and histological evaluati on was performed in 40 patients before inclusion in the study. Patient s were randomized into three treatment groups: (a) conventional therap y plus IFN, (b) conventional therapy plus thymomodulin and (c) convent ional therapy alone Two-year follow-up included repeated endomyocardia l biopsy, echocardiographic evaluation, treadmill exercise rest, Holte r monitoring study and radionuclide assessment of left ventricular fun ction during exercise. Left ventricular ejection fraction increased du ring follow-up in most of the IFN- and thymomodulin-treated patients, and only in a few of conventionally treated patients. Left ventricular reserve was significantly higher at 2-year follow-up in patients trea ted with immnnomodlklatos. No serious adverse effects were noticed dur ing treatment. Our results suggest that treatment of myocarditis and/o r IDC with IFN or thymomodulin induces an earlier and significantly su perior clinical improvement than conventional therapy alone.