Transient ventricular wall thickening in acute myocarditis: a serial echocardiographic and histopathologic study

Jpn Circ J. 2001 Oct;65(10):863-6. doi: 10.1253/jcj.65.863.


The present study was designed to determine whether the wall thickening seen in acute myocarditis is caused by interstitial edema. The study group comprised 25 patients (idiopathic myocarditis, 17; eosinophilic myocarditis, 8) in whom acute myocarditis was diagnosed histologically and who underwent echocardiography and endomyocardial biopsy during both the acute and convalescent phases. The following echocardiographic parameters were measured: interventricular septum and left ventricular posterior wall thickness, left ventricular end-diastolic dimension, and left ventricular ejection fraction. Based on the myocardial biopsy specimens, the degree of interstitial edema was classified into 3 grades [(-), 1(+), 2(+)] and the transverse diameter of cardiac myocytes was measured using light microscopy. The thickness of both the interventricular septum and left ventricular wall decreased from 14.3+/-3.7 mm and 13.3+/-2.4 mm in the acute phase to 9.7+/-1.7 mm (p<0.001) and 10.2+/-1.7 mm (p<0.0001), respectively, in the convalescent phase. Edema was present in 22 patients (88.0%) in the acute phase, but in the convalescent phase, edema was present in only 7 patients (28.0%), indicating a significant reduction in the degree of edema (p<0.0001). Cardiac myocyte diameter did not differ significantly between the acute (13.6+/-1.1 microm) and convalescent (13.8+/-1.8 microm) phases.

Publication types

  • Clinical Trial
  • Review

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Biopsy
  • Cell Size
  • Child
  • Echocardiography
  • Edema, Cardiac / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocarditis / diagnostic imaging
  • Myocarditis / pathology*
  • Myocardium / pathology
  • Statistics, Nonparametric
  • Time Factors
  • Ventricular Remodeling*