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November 9, 1998

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Heart Inflammation Declining In The United States

Cases of life-threatening heart muscle inflammation are declining in the United States, mirroring a decline in enteroviral infections that often lead to the inflammation, according to a Johns Hopkins study.

"We have seen a decline in the number of cases of inflammation, known as viral myocarditis, at The Johns Hopkins Hospital since the mid-1980s, but there may be a resurgence at some point, as the cases tend to follow epidemic as well as pandemic patterns," says Robert E. McCarthy III, M.D., lead author of the study and an assistant professor of medicine at Hopkins.

Results of the study will be presented at 1:30 p.m., Nov. 9 at the American Heart Association's 71st annual Scientific Sessions in Dallas.

Researchers took biopsies of the hearts of 1,757 patients who came to Hopkins between 1985 and 1996 with new-onset heart failure or abnormal heart rhythms. Myocarditis was present in 157 patients (9 percent) who had no other disease associated with heart inflammation.

The number and proportion of patients with primary myocarditis decreased significantly during the time period, from 22 (28 percent) in 1985 to three (2 percent) in 1996. Furthermore, since 1991, myocarditis was present in less than 5 percent of patients biopsied each year. This correlates with the annual reduction of enterovirus cases reported by the federal Centers for Disease Control and Prevention since 1993.

"Knowing that cases of myocarditis could follow an epidemic, continued efforts to improve the diagnosis and treatment of this disorder are warranted," McCarthy says.

The study's other authors are Ralph H. Hruban, M.D.; Joshua M. Hare, M.D.; Edward K. Kasper, M.D.; and Kenneth L. Baughman, M.D.

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