ABSTRACT
In 22 patients with heart failure and/or ventricular arrhythmias presumably of inflammatory etiology the results of clinical and instrumental investigation were analyzed and compared to the endomyocardial biopsy data. In the subgroup of patients with left bundle branch block (LBBB) we revealed features indicative of lesser contribution of inflammatory destruction in pathogenesis of cardiomyopathy. The only virus, detected in biopsy samples, was parvovirus B19. Its persistence in myocardium was not related to activity of inflammation and severity of clinical course. Increased expression of Coxsackie adenovirus receptor (CAR) was found in 20 patients. It was not related to inflammatory cells infiltration and virus persistence in myocardium. Patients with most prominent CAR expression were characteried by right heart dilatation, more severe heart failure and absence of LBBB. Enhancement of CAR expression could reflect the attempt of organism to repair intercellular communications between cardiomyocites and to protect cells from the products of necrotic lysis during long standing inflammation.
Subject(s)
Arrhythmias, Cardiac , Coxsackie and Adenovirus Receptor-Like Membrane Protein/immunology , Heart Conduction System/abnormalities , Heart Failure , Heart Ventricles , Myocarditis , Adult , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/immunology , Arrhythmias, Cardiac/physiopathology , Biopsy , Brugada Syndrome , Bundle-Branch Block/immunology , Bundle-Branch Block/physiopathology , Cardiac Conduction System Disease , Female , Heart Conduction System/immunology , Heart Conduction System/physiopathology , Heart Failure/diagnosis , Heart Failure/etiology , Heart Failure/physiopathology , Heart Function Tests/methods , Heart Ventricles/pathology , Heart Ventricles/physiopathology , Humans , Male , Middle Aged , Monitoring, Immunologic , Myocarditis/complications , Myocarditis/immunology , Myocarditis/pathology , Prognosis , Risk Assessment , Severity of Illness Index , Statistics as TopicABSTRACT
Human heart muscle proteins have been analyzed by two-dimensional electrophoresis. Twenty five autopsy heart muscle samples obtained from individuals who had died in accidents and who had no signs of cardiovascular pathology have been compared with biopsy and autopsy myocardium samples of patients with: dilated cardiomyopathy (5 cases), hypertrophical cardiomyopathy (2 cases) and myocarditis (2 cases). In dilated cardiomyopathy in 3 out of 5 cases an additional protein spot was found in the myocardial myosin light chain 1 area.