Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone

J. D. Hosenpud, J. H. McAnulty, Nelson (Sam) Niles

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Six patients with myocarditis documented by biopsy, after a baseline right heart catheterization and echocardiogram, underwent treatment with azathioprine and prednisone. After 3 months of treatment, biopsy, right heart catheterization, and echocardiogram were repeated. In addition to the immunosuppressive therapy, most patients received additional conventional medications for heart failure between evaluation periods (mean number of cardiac drugs increased from 1.7 ± 1.0 to 2.7 ± 0.05, p = 0.041). Mean heart rate decreased (105 ± 14 to 84 ± 13 beats/min, p = 0.016), as did pulmonary wedge pressure (23 ± 8 to 12 ± 4 mm Hg, p = 0.012). There were no significant changes in cardiac index (3.1 ± 0.8 to 2.9 ± 1.0 liters/min), end-diastolic dimension (62 ± 13 to 62 ± 12 mm) or fractional shortening (11 ± 6 to 12 ± 3%) with treatment. Complications from immunosuppressive therapy included severe soft tissue infection, acute psychosis and adrenal insufficiency in one patient each. The benefits from prednisone and azathioprine in this group of patients have not been demonstrated. Although heart rate and pulmonary wedge pressure decreased, these changes could be ascribed to increases in the conventional therapy for heart failure. Finally, there is a high incidence of side effects from prednisone and azathioprine therapy. These findings suggest that this unproven therapy for myocarditis should be limited to experimental protocols.

Original languageEnglish (US)
Pages (from-to)797-801
Number of pages5
JournalJournal of the American College of Cardiology
Volume6
Issue number4
StatePublished - 1985

Fingerprint

Ventricular Function
Myocarditis
Azathioprine
Prednisone
Pulmonary Wedge Pressure
Therapeutics
Immunosuppressive Agents
Cardiac Catheterization
Heart Failure
Heart Rate
Biopsy
Adrenal Insufficiency
Soft Tissue Infections
Psychotic Disorders
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone. / Hosenpud, J. D.; McAnulty, J. H.; Niles, Nelson (Sam).

In: Journal of the American College of Cardiology, Vol. 6, No. 4, 1985, p. 797-801.

Research output: Contribution to journalArticle

@article{bd7477f62b47493484bc6cd1f26b614b,
title = "Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone",
abstract = "Six patients with myocarditis documented by biopsy, after a baseline right heart catheterization and echocardiogram, underwent treatment with azathioprine and prednisone. After 3 months of treatment, biopsy, right heart catheterization, and echocardiogram were repeated. In addition to the immunosuppressive therapy, most patients received additional conventional medications for heart failure between evaluation periods (mean number of cardiac drugs increased from 1.7 ± 1.0 to 2.7 ± 0.05, p = 0.041). Mean heart rate decreased (105 ± 14 to 84 ± 13 beats/min, p = 0.016), as did pulmonary wedge pressure (23 ± 8 to 12 ± 4 mm Hg, p = 0.012). There were no significant changes in cardiac index (3.1 ± 0.8 to 2.9 ± 1.0 liters/min), end-diastolic dimension (62 ± 13 to 62 ± 12 mm) or fractional shortening (11 ± 6 to 12 ± 3{\%}) with treatment. Complications from immunosuppressive therapy included severe soft tissue infection, acute psychosis and adrenal insufficiency in one patient each. The benefits from prednisone and azathioprine in this group of patients have not been demonstrated. Although heart rate and pulmonary wedge pressure decreased, these changes could be ascribed to increases in the conventional therapy for heart failure. Finally, there is a high incidence of side effects from prednisone and azathioprine therapy. These findings suggest that this unproven therapy for myocarditis should be limited to experimental protocols.",
author = "Hosenpud, {J. D.} and McAnulty, {J. H.} and Niles, {Nelson (Sam)}",
year = "1985",
language = "English (US)",
volume = "6",
pages = "797--801",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Lack of objective improvement in ventricular systolic function in patients with myocarditis treated with azathioprine and prednisone

AU - Hosenpud, J. D.

AU - McAnulty, J. H.

AU - Niles, Nelson (Sam)

PY - 1985

Y1 - 1985

N2 - Six patients with myocarditis documented by biopsy, after a baseline right heart catheterization and echocardiogram, underwent treatment with azathioprine and prednisone. After 3 months of treatment, biopsy, right heart catheterization, and echocardiogram were repeated. In addition to the immunosuppressive therapy, most patients received additional conventional medications for heart failure between evaluation periods (mean number of cardiac drugs increased from 1.7 ± 1.0 to 2.7 ± 0.05, p = 0.041). Mean heart rate decreased (105 ± 14 to 84 ± 13 beats/min, p = 0.016), as did pulmonary wedge pressure (23 ± 8 to 12 ± 4 mm Hg, p = 0.012). There were no significant changes in cardiac index (3.1 ± 0.8 to 2.9 ± 1.0 liters/min), end-diastolic dimension (62 ± 13 to 62 ± 12 mm) or fractional shortening (11 ± 6 to 12 ± 3%) with treatment. Complications from immunosuppressive therapy included severe soft tissue infection, acute psychosis and adrenal insufficiency in one patient each. The benefits from prednisone and azathioprine in this group of patients have not been demonstrated. Although heart rate and pulmonary wedge pressure decreased, these changes could be ascribed to increases in the conventional therapy for heart failure. Finally, there is a high incidence of side effects from prednisone and azathioprine therapy. These findings suggest that this unproven therapy for myocarditis should be limited to experimental protocols.

AB - Six patients with myocarditis documented by biopsy, after a baseline right heart catheterization and echocardiogram, underwent treatment with azathioprine and prednisone. After 3 months of treatment, biopsy, right heart catheterization, and echocardiogram were repeated. In addition to the immunosuppressive therapy, most patients received additional conventional medications for heart failure between evaluation periods (mean number of cardiac drugs increased from 1.7 ± 1.0 to 2.7 ± 0.05, p = 0.041). Mean heart rate decreased (105 ± 14 to 84 ± 13 beats/min, p = 0.016), as did pulmonary wedge pressure (23 ± 8 to 12 ± 4 mm Hg, p = 0.012). There were no significant changes in cardiac index (3.1 ± 0.8 to 2.9 ± 1.0 liters/min), end-diastolic dimension (62 ± 13 to 62 ± 12 mm) or fractional shortening (11 ± 6 to 12 ± 3%) with treatment. Complications from immunosuppressive therapy included severe soft tissue infection, acute psychosis and adrenal insufficiency in one patient each. The benefits from prednisone and azathioprine in this group of patients have not been demonstrated. Although heart rate and pulmonary wedge pressure decreased, these changes could be ascribed to increases in the conventional therapy for heart failure. Finally, there is a high incidence of side effects from prednisone and azathioprine therapy. These findings suggest that this unproven therapy for myocarditis should be limited to experimental protocols.

UR - http://www.scopus.com/inward/record.url?scp=0022389532&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022389532&partnerID=8YFLogxK

M3 - Article

VL - 6

SP - 797

EP - 801

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 4

ER -