Dilated cardiomyopathy and myocarditis in Kenya: an endomyocardial biopsy study

• Published in: International journal of cardiology Vol. 41; no. 2; pp. 157 - 163
• Main Authors: Sanderson, J.E., Olsen, E.G.J., Gatei, D.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.09.1993; Elsevier Science
• Subjects: Adult; Africa; Biological and medical sciences; Biopsy; Cardiomyopathy, Dilated - pathology; Cardiovascular system; Developing Countries; Dilated cardiomyopathy; Endocardium - pathology; Endomyocardial biopsy; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Kenya; Leukocyte Count; Male; Medical sciences; Microscopy, Electron; Middle Aged; Myocarditis; Myocarditis - pathology; Myocardium - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; T-Lymphocyte Subsets - pathology; Kenya; Africa; Myocarditis; Endomyocardial biopsy; Dilated cardiomyopathy; Africa; Human; Pathology; Race; Negroid; Cardiovascular disease; Exploration; Constrictive hypertrophic cardiomyopathy
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/0167-5273(93)90156-B

We have studied, by light and electron microscopy, left ventricular endomyocardial biopsy specimens from 18 African patients (14 men) with idiopathic dilated cardiomyopathy in Nairobi. Nine patients (50%) had evidence of healing myocarditis, that is the presence of a mild inflammatory cell infiltration within the myocardium. Interstitial fibrosis was prominent in five patients (28%) and in all 18 specimens there were hypertrophied muscle fibres. Therefore, half of the patients with idiopathic dilated cardiomyopathy had histological signs of a previous myocarditis. There was no serological evidence of a previous or recent coxsackie infection or any other common viral infections. It seems probable that the myocarditis was due to an inappropriate immunological reaction to myocardial muscle.