[Differential assessment of myocardial diseases: hemodynamic-angiocardiography studies and etiologic classification]

Subject of our study are 293 patients with diseases of the myocardium, 212 males and 81 females at the average age of 45.2 years who were examined invasively including biopsy of the endomyocardium on account of clinical symptoms and changes of the ECG. Patients with hypertension, vitia, coronary stenoses as well as with hypertrophic cardiomyopathy were excluded. The aims of our study were a precised assessment of the degree of severity by a score from invasive parameters, the characterization of so-called latent or beginning cardiomyopathies and their relations to the dilatative cardiomyopathy as well as the aetiological classification by the biopsy of the endomyocardium. The score resulted from the number and the degree of individual pathological parameters, in which case the degree of the deviation was confirmed with points between 0 and 3. By summarizing of the score three degrees of severity were defined, to which clinical, electrocardiographic and bioptic results were coordinated. In the degree of severity 1 were 170 patients, in the degree of severity 2 42 patients, in the degree of severity 3 81 patients. In the higher degree of severity dyspnoea was significantly more frequently stated. In all degrees of severity the decrease of function was nearly of the same frequency. Of the degree of severity 3 died 28 patients, of the degree of severity 2 1 patient. In the degree of severity 1 by the biopsy of the endomyocardium in greater than 80% aetiological clues were detected, only in 35% in the degree of severity 3. Inflammatory changes were relatively frequently observed in all degrees of severity.(ABSTRACT TRUNCATED AT 250 WORDS)