[Histologic response of the myocardium to various immunosuppressor schedules in patients with dilated cardiomyopathy and diagnosis of myocarditis at endomyocardial biopsy]. / Resposta histológica do miocárdio a diferentes esquemas imunossupressores em pacientes com cardiomiopatia dilatada e diagnóstico de miocardite biópsia endomiocárdica.

ABSTRACT

PURPOSE: To analyse the histological evolution of endomyocardial biopsies from children with active myocarditis, submitted or not to immunosuppressive therapy. PATIENTS AND METHODS: Four groups of patients were compared, clinically treated as follows group I--anticongestive drugs (4 patients); group II--prednisone (5 patients); group III--prednisone plus azathioprine (9 patients); group IV--prednisone and cyclosporine (5 patients). RESULTS: No patient from group I presented any histological improvement during a mean period of 9 months, while evident histological improvement occurred in 25% of patients from group I, 67% from group III and 80% from group IV. The microscopical aspect of resolving myocarditis was only observed in patients from groups III and IV, after treatment. CONCLUSION: The immunosuppressive therapy with azathioprine or cyclosporine plus prednisone leads to decrease of active myocarditis intensity in a higher proportion of cases than the treatment with only prednisone or no immunosuppressive drugs.