Conclusions
The main results of our study are: (1) Compared with patients with DCM, patients with TCM demonstrated significantly stronger myocardial expression of major histocompatibility complex class II molecule and an equal amount of infiltration with CD3+ T-cells and CD68+ macrophages. (2) Compared with patients with inflammatory cardiomyopathy, the presence of T-cells and macrophages was significantly lower in TCM. (3) Myocardial fibrosis was detected to a lower degree in patients with TCM compared with DCM and ICM. (4) The marker of apoptosis (cleaved caspase 3) was comparably elevated in TCM and ICM patients and significantly lower in the DCM group. Finally, we were not able to demonstrate on an immunohistological level significant differences neither in TCM patients in sinus rhythm versus atrial fibrillation at baseline nor in TCM patients with LVEF improvement larger than the mean of the total cohort (21 %) compared to TCM patients with less LVEF improvement.
Further prospective studies are warranted for better characterization of patients with TCM by EMB, which could help identify patients with TCM.
Conflict of interest: none declared