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Respiratory virus infections are common and often recurrent in patients with severe CD4+ T lymphopenia. However, the mortality was low, which may have been due to early institution of antiviral treatment or reduced inflammatory damage to the lungs due to severe lymphopenia.

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SUMMARY Suppressor T lymphocyte function was examined in 11 patients with idiopathic congestive cardiomyopathy and in 11 age and sex matched patients with a similar degree of heart failure resulting from ischaemic heart disease. Suppressor T lymphocyte function was also assessed in a control population of 11 normal subjects. Suppressor T lymphocyte function was reduced in both groups of patients with heart failure but not significantly, and a wide range of suppression was demonstrated in all groups.These data do not support the hypothesis that there is a defect in T lymphocyte function in patients with congestive cardiomyopathy, but they do suggest that there may be a non-specific reduction in T lymphocyte suppressor function associated with heart failure in general.The aetiology of idiopathic congestive cardiomyopathy is, by definition, unknown and is likely to represent the end stage of several different pathogenic mechanisms."2 The possibility that immunological abnormalities may affect the pathogenesis of some cases has received much attention in recent years.34 There have been reports of impaired suppressor T lymphocyte function in patients with congestive cardiomyopathy and this could be the result of a quantitative or a qualitative abnormality.5'6 Such a defect might be determined genetically by predisposing an individual to viral infection, myocarditis, and subsequent development of cardiomyopathy.7 This hypothesis has not, however, been accepted by all workers8 and some studies have shown no specific abnormality of T lymphocyte function in congestive cardiomyopathy.9These doubts regarding the role of immunological abnormalities in the pathogenesis of congestive cardiomyopathy prompted a study to determine whether patients with congestive cardiomyopathy have a defect of suppressor T lymphocyte function that is specific to their disease.Requests for reprints to Dr Patricia J Lowry, Department of Cardiovascular Medicine, East Birmingham Hospital, Bordesley Green East, Birmingham B9 5ST.Accepted for publication 11 December 1986 Patients and methods PATIENTSEleven patients with idiopathic congestive cardiomyopathy (according to the classification of Goodwin and Oakley)' that was confirmed by cardiac catheterisation, coronary angiography, and left ventricular endomyocardial biopsy were studied and compared with eleven individually age and sex matched patients who had congestive cardiac failure of ischaemic origin, also confirmed at cardiac catheterisation. We also studied eleven healthy controls recruited from hospital staff with no personal or family history of ischaemic heart disease.The severity of congestive cardiac failure and the treatment regimens were similar in the patient groups (table). All patients in the heart failure groups were being treated with digoxin and warfarin. Ejection fractions were determined by volumes derived from end systolic and end diastolic frames acquired at left ventricular cineangiography. o METHODS Lymphocytes were separated from heparinised blood by density gradient cent...