RESUMO
Three patterns of kininogenetic changes: enhanced (50% of patients), depressed (40%) and qualitatively-different (10%) kininogenesis, were identified through 3 measurements of blood kallikrein-kinin (BKK) activity by kininogenase techniques in patients with infectious allergic myocarditis and myocarditic cardiosclerosis. The intensity of individual phases of kininogenesis is conditioned by the activity of total plasma kallikrein, its conformation and the level of kallikrein inhibitors. During the activated kininogenesis phase, a direct relation can be seen between changes in the activity of the above-mentioned parameters and clinical severity of the disease. The measurement of total kallikrein activity, kaolin adsorption of this enzyme, and kallikrein inhibitors may be useful as an additional diagnostic test. The pattern of changes in BKK activity parameters may be indicative of persisting or progressing myocardial inflammatory allergic process in patients with myocarditic cardiosclerosis. The treatment for myocarditis with conventional anti-inflammatory agents, leaving out the drugs controlling kininogenetic changes, fails to produce complete recovery and the normalization of BKK activity.
