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British Heart Journal logoLink to British Heart Journal
. 1986 Sep;56(3):285–291. doi: 10.1136/hrt.56.3.285

Peripartum heart disease: an endomyocardial biopsy study.

J E Sanderson, E G Olsen, D Gatei
PMCID: PMC1236855  PMID: 3756045

Abstract

Endomyocardial biopsies were performed in 11 African women in Nairobi who presented with the clinical features of peripartum cardiomyopathy. The samples were studied by light and electron microscopy. In five patients there was evidence of a "healing myocarditis", that is the presence of a mild inflammatory cell infiltration within the myocardium with foci of necrosis and variable amounts of hypertrophy and fibrosis. Of the nine patients who were followed up, three out of four with myocarditis had persistent heart failure and four out of five without myocarditis improved. Peripheral blood T lymphocyte cell subsets were measured in nine patients by means of monoclonal antibodies. A high helper:suppressor T cell ratio was found in three patients. Almost half of this group of patients with peripartum cardiomyopathy had myocarditis in their biopsy specimens. The myocarditis may have been due to an inappropriate immunological reaction in some patients.

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Selected References

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  1. Amino N., Mori H., Iwatani Y., Tanizawa O., Kawashima M., Tsuge I., Ibaragi K., Kumahara Y., Miyai K. High prevalence of transient post-partum thyrotoxicosis and hypothyroidism. N Engl J Med. 1982 Apr 8;306(14):849–852. doi: 10.1056/NEJM198204083061405. [DOI] [PubMed] [Google Scholar]
  2. Baandrup U., Florio R. A., Olsen E. G. Do endomyocardial biopsies represent the morphology of the rest of the myocardium? A quantitative light microscopic study of single v. multiple biopsies with the King's bioptome. Eur Heart J. 1982 Apr;3(2):171–178. doi: 10.1093/oxfordjournals.eurheartj.a061281. [DOI] [PubMed] [Google Scholar]
  3. Blegen S. D. Post-partum congestive heart failure. Beri-beri heart disease. Acta Med Scand. 1965 Oct;178(4):515–524. doi: 10.1111/j.0954-6820.1965.tb04296.x. [DOI] [PubMed] [Google Scholar]
  4. Brockington I. F. Postpartum hypertensive heart failure. Am J Cardiol. 1971 Jun;27(6):650–658. doi: 10.1016/0002-9149(71)90231-1. [DOI] [PubMed] [Google Scholar]
  5. Brooksby I. A., Swanton R. H., Jenkins B. S., Webb-Peploe M. M. Long sheath technique for introduction of catheter tip manometer or endomyocardial bioptome into left or right heart. Br Heart J. 1974 Sep;36(9):908–912. doi: 10.1136/hrt.36.9.908. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cambridge G., MacArthur C. G., Waterson A. P., Goodwin J. F., Oakley C. M. Antibodies to Coxsackie B viruses in congestive cardiomyopathy. Br Heart J. 1979 Jun;41(6):692–696. doi: 10.1136/hrt.41.6.692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Davidson N. M., Parry E. H. Peri-partum cardiac failure. Q J Med. 1978 Oct;47(188):431–461. [PubMed] [Google Scholar]
  8. Demakis J. G., Rahimtoola S. H. Peripartum cardiomyopathy. Circulation. 1971 Nov;44(5):964–968. doi: 10.1161/01.cir.44.5.964. [DOI] [PubMed] [Google Scholar]
  9. Falase A. O. Cardiomegaly of unknown origin among Nigerian adults: role of hypertension in its aetiology. Br Heart J. 1977 Jun;39(6):671–679. doi: 10.1136/hrt.39.6.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Fowles R. E., Bieber C. P., Stinson E. B. Defective in vitro suppressor cell function in idiopathic congestive cardiomyopathy. Circulation. 1979 Mar;59(3):483–491. doi: 10.1161/01.cir.59.3.483. [DOI] [PubMed] [Google Scholar]
  11. Froelich C. J., Goodwin J. S., Bankhurst A. D., Williams R. C., Jr Pregnancy, a temporary fetal graft of suppressor cells in autoimmune disease? Am J Med. 1980 Sep;69(3):329–331. [PubMed] [Google Scholar]
  12. Homans D. C. Peripartum cardiomyopathy. N Engl J Med. 1985 May 30;312(22):1432–1437. doi: 10.1056/NEJM198505303122206. [DOI] [PubMed] [Google Scholar]
  13. Kawai C., Takatsu T. Clinical and experimental studies on cardiomyopathy. N Engl J Med. 1975 Sep 18;293(12):592–597. doi: 10.1056/NEJM197509182931207. [DOI] [PubMed] [Google Scholar]
  14. MEADOWS W. R. Idiopathic myocardial failure in the last trimester of pregnancy and the puerperium. Circulation. 1957 Jun;15(6):903–914. doi: 10.1161/01.cir.15.6.903. [DOI] [PubMed] [Google Scholar]
  15. Melvin K. R., Richardson P. J., Olsen E. G., Daly K., Jackson G. Peripartum cardiomyopathy due to myocarditis. N Engl J Med. 1982 Sep 16;307(12):731–734. doi: 10.1056/NEJM198209163071207. [DOI] [PubMed] [Google Scholar]
  16. Obeyesekere I., Hermon Y. Arbovirus heart disease: myocarditis and cardiomyopathy following dengue and chikungunya fever--a follow-up study. Am Heart J. 1973 Feb;85(2):186–194. doi: 10.1016/0002-8703(73)90459-6. [DOI] [PubMed] [Google Scholar]
  17. Richardson P. J. King's endomyocardial bioptome. Lancet. 1974 Apr;1(7859):660–661. doi: 10.1016/s0140-6736(74)93204-8. [DOI] [PubMed] [Google Scholar]
  18. Sanderson J. E., Adesanya C. O., Anjorin F. I., Parry E. H. Postpartum cardiac failure--heart failure due to volume overload? Am Heart J. 1979 May;97(5):613–621. doi: 10.1016/0002-8703(79)90189-3. [DOI] [PubMed] [Google Scholar]
  19. Sanderson J. E., Koech D., Iha D., Ojiambo H. P. T-lymphocyte subsets in idiopathic dilated cardiomyopathy. Am J Cardiol. 1985 Mar 1;55(6):755–758. doi: 10.1016/0002-9149(85)90151-1. [DOI] [PubMed] [Google Scholar]
  20. Woodruff J. F. Viral myocarditis. A review. Am J Pathol. 1980 Nov;101(2):425–484. [PMC free article] [PubMed] [Google Scholar]

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