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[The viral and immunological characteristics of cardiomyopathies and myocarditis]
Insights
Virus infections can trigger acute myocarditis (MC) and congestive cardiomyopathy (CMP). Autoimmune factors are key in heart failure cases, with potential links to myocardial denervation and Epstein-Barr virus.
Area of Science:
- Cardiology
- Immunology
- Virology
Background:
- Myocardial lesions encompass various conditions including cardiomyopathy (CMP), myocarditis (MC), and heart injury.
- Understanding the interplay between viral infections and autoimmune responses is crucial for diagnosing and treating heart conditions.
Purpose of the Study:
- To investigate the etiological roles of viral infections and autoimmune mechanisms in myocardial lesions.
- To explore potential links between specific immune responses, viral presence, and heart failure development.
- To assess the utility of immunological parameters in evaluating treatment efficacy.
Main Methods:
- Virological testing for Coxsackie B, Epstein-Barr, and hepatitis B viruses.
- Comprehensive immunoassays including antibody detection, cellular cytotoxicity tests, and lymphocyte subset analysis.
- Examination of 97 patients with diverse myocardial lesions like congestive CMP, postmyocarditis CMP, MC, alcoholic heart injury, and coronary heart disease.
Main Results:
- Virus infection implicated in acute myocarditis (MC) and congestive cardiomyopathy (CMP).
- Autoimmune mechanisms confirmed in MC with heart failure and postmyocarditis CMP (PM CMP).
- Evidence of myocardial denervation suggested in congestive CMP and alcoholic heart injury (AHI) with heart failure, linked to T-lymphocyte deficiency and Epstein-Barr virus antibodies.
Conclusions:
- Both viral and autoimmune pathways contribute to myocardial damage.
- Specific immune profiles may indicate myocardial denervation and refractory heart failure.
- Immunological markers can objectively assess glucocorticoid treatment effectiveness in MC and PM CMP.
Abstract:
As many as 97 patients with myocardial lesions: congestive and hypertrophic cardiomyopathy (CMP), postmyocarditis CMP (PM CMP), myocarditis (MC), alcoholic heart injury (AHI), coronary heart disease (CHD), vegetodysovarian myocardiodystrophy were examined by means of a complex of the virological tests (for Coxsackie B, Epstein-Barr and hepatitis B viruses) and immunoassays (for antibodies to different components of the myocardium, leukocyte migration inhibition test, antibody-dependent cellular cytotoxicity test, measurements of T and B lymphocytes and their subpopulations, and so forth). Virus infection was shown to be of a role for the onset of acute MC (usually reversible) and congestive CMP. At the same time the autoimmune mechanisms of the lesions were conclusively ascertained in MC associated with heart failure and in PM CMP. In patients with congestive CMP and AHI coupled with heart failure, antibodies to nerve fibers of the myocardium could be demonstrated in the presence of T-lymphocyte deficiency and high titers of antibodies to Epstein-Barr virus. This does not allow excluding myocardial denervation leading to refractory heart failure. Some immunological parameters made use of in the study provide an opportunity of an objective evaluation of the effect glucocorticoid treatment produces on patients suffering from MC and PM CMP.