[Dilated and ischemic cardiomyopathy: differential diagnosis]. / Dilatatsionnaia i ishemicheskaia kardiomiopatiia: voprosy differentsial'noi diagnostiki.

A uniform set of differential-diagnostic methods was used in 45 patients with dilated cardiomyopathy (DCMP) and 36 patients with ischemic cardiomyopathy (ICMP). The following parameters, significant for differentiation of the above diseases, have been defined: case history data, more deep decrease of global myocardial contractility and dilation of cardiac chambers, prevalence of increased linear sizes of the right ventricle, reduction of linear sizes of the aorta and left ventricular hypertrophy in DCMP; a different direction of left ventricular contractility index in dobutamine test.

[Cardiogenic shock in dilated cardiomyopathy]. / Kardiogennyi shok pri dilatatsionnoi kardiomiopatii.

The present communication is based on an examination of 33 cases with dilated cardiomyopathy and 48 with severe myocarditis. Nine patients with dilated cardiomyopathy were diagnosed as having developed cardiogenic shock. Clinical examination, echocardiography, right heart and pulmonary artery probing were performed. Cardiogenic shock in dilated cardiomyopathy was demonstrated to be characterized by a progressive decrease in cardiac contractility, no increase in peripheral vascular resistance, and high pulmonary hypertension. Profound cardiomyocyte alterations followed by increased fibrosis of intermuscular and perivascular spaces contribute to the development of cardiogenic shock in dilated cardiomyopathy.

[Characteristics of the course of complicated myocarditis]. / Osobennosti techeniia oslozhnennogo miokardita.

Twenty one patients (15 males and 6 females, mean age, 35.0 +/- 1.6 years) with myocarditis combined with symptoms of Stages II-III circulatory failure were examined. This group of patients was identified as a high-risk group as to an unfavourable outcome of myocarditis. Within the follow-up from 3 to 36 months, all the patients died: the case of death was arrhythmia in 17 and circulatory failure in 4. The unfavourable prognosis of the disease was evidenced by high pulmonary capillary pressure and pulmonary end-diastolic pressure that exceeded 20 mm Hg the cardiac index that was less than 31/min.m-2. The ratio of left ventricular end-systolic and end-diastolic volumes to the left ventricular cross-shortening were important signs of the unfavourable prognosis, i.e. death of congestive circulatory failure. In addition to complications of myocarditis such as sudden ventricular fibrillation, progressive congestive circulatory failure and thromboembolism, there were more rare complications such as development of left ventricular aneurysms and damage to the endocardium as abacterial endocarditis.

[Various factors determining the fatal outcome in myocarditis]. / O nekotorykh faktorach, opredeliaiushchikh letal'nyi iskhod pri miokarditakh.

A study of 38 patients with infectious-allergic myocarditis included clinical laboratory investigation, echocardiography, catheterization of the right heart compartments and the pulmonary artery and endomyocardial biopsy. It has identified adverse factors contributing to fatal outcome: increased end-diastolic pressure in the pulmonary artery, low cardiac output, signs of macrofocal fibrosis and small ejection fraction.