DILATED CARDIOMYOPATHY AND MYOCARDITIS IN KENYA - AN ENDOMYOCARDIAL BIOPSY STUDY

We have studied, by light and electron microscopy, left ventricular en domyocardial biopsy specimens from 18 African patients (14 men) with i diopathic dilated cardiomyopathy in Nairobi. Nine patients (50%) had e vidence of healing myocarditis, that is the presence of a mild inflamm atory cell infiltration within the myocardium. Interstitial fibrosis w as prominent in five patients (28%) and in all 18 specimens there were hypertrophied muscle fibres. Therefore, half of the patients with idi opathic dilated cardiomyopathy had histological signs of a previous my ocarditis. There was no serological evidence of a previous or recent c oxsackie infection or any other common viral infections. It seems prob able that the myocarditis was due to an inappropriate immunological re action to myocardial muscle.