Is acute cardiac rejection a model of myocarditis in humans?

Publisher Website
Google Scholar
Abstract
Both acute cardiac rejection and acute idiopathic myocarditis may present with similar clinical signs, including heart failure. Morphologically, both may be defined as an inflammatory infiltrate (predominantly T lymphocytes) of the myocardium causing injury to adjacent myocytes. In both cases, the diffuse inflammatory infiltrate involves the endocardium, myocardium and pericardium. The morphological sequence of progression is similar. Acute rejection appears to be a good morphological model of myocarditis. From the acute rejection model it is known that myocardial damage must be diffuse and with considerable necrosis before heart failure occurs. It follows that patients suspected of having myocarditis and presenting in heart failure would be expected to have the equivalent of ‘moderate rejection’ and not a small focus of inflammatory cells on which the endomyocardial biopsy diagnosis of myocarditis is sometimes made. Such focal myocarditis may result in a clinical presentation of arrhythmias, but should not cause florid heart failure. If heart failure is present, other causes for it should be sought before a diagnosis of myocarditis is made.

This publication has 0 references indexed in Scilit: