LEFT-VENTRICULAR DIASTOLIC DYSFUNCTION IN LYMPHOCYTIC MYOCARDITIS AS ASSESSED BY DOPPLER-ECHOCARDIOGRAPHY

Pulsed-wave Doppler echocardiography of left ventricular (LV) inflows was performed in 30 consecutive patients with biopsy-proven lymphocyti c myocarditis. There were 21 men and 9 women (mean age 50 +/- 15 years ). LV ejection fraction was less than or equal to 30% in 73% of the pa tients. Sixty-six percent were in New York Heart Association functiona l class III to IV. Peak early (E) velocity, late (A) velocity, deceler ation time and filling pattern were assessed. These values were compar ed with a control population. E velocity in lymphocytic myocarditis wa s significantly higher than in control subjects (79 +/- 34 vs 67 +/- 1 4 cm/s, p = 0.0034). A velocity was lower in patients with myocarditis than in control subjects (38 +/- 20 vs 49 +/- 12 cm/s, p = 0.0001). C orrespondingly, the E/A ratio was greater in the myocarditis group (2. 5 +/- 1.3 vs 1.5 +/- 0.5, p <0.0001). In particular, mean deceleration time in patients with myocarditis was significantly lower than that o f control subjects (151 +/- 52 vs 194 +/- 30 ms, p <0.0001). Diastolic filling patterns were abnormal in 29 of 30 patients (97%) with lympho cytic myocarditis, revealing a restrictive pattern in 25, abnormal rel axation in 4 and a normal pattern in 1. Lymphocytic myo-carditis is th erefore associated with LV diastolic dysfunction of a predominantly re strictive pattern.