[Patho- and morphogenesis of infectious myocarditis]

Area of Science:

• Cardiovascular pathology
• Immunology
• Infectious diseases

Background:

• Infectious myocarditis is a serious condition affecting the heart.
• Understanding the pathogenesis of infectious myocarditis is crucial for effective treatment.

Purpose of the Study:

• To investigate the pathological changes and immune responses in infectious myocarditis.
• To elucidate the pathogenesis of infectious myocarditis.

Main Methods:

• Experimental infection of white mice with various pathogens (influenza virus, Staphylococcus, Pseudomonas aeruginosa, Escherichia coli, Proteus).
• Histopathological examination of cardiac tissue at different time points.
• Immunological assays in human patients, including detection of cardiac antigen, anticardiac antibodies, blast transformation tests, and T cell counts.
• Coons's method to detect antibodies against myocardial and connective tissue structures.

Main Results:

• Early (2-3 days) toxic vascular, stromal, and cardiomyocyte damage observed in mice, followed by inflammation and cardiosclerosis foci by 3-4 weeks.
• Immune disorders in human patients included cardiac antigen in 24%, anticardiac antibodies in 22%, positive blast transformation tests in 7.5%, and reduced T cells.
• Late-stage staphylococcal angina patients showed antibodies to myocardial (45.7%) and connective tissue (36.1-31.4%), with some exhibiting myocarditis signs.

Conclusions:

• Infectious agents induce significant cardiac damage and inflammation, leading to cardiosclerosis.
• Immune system dysregulation, including autoantibody production, plays a role in the pathogenesis of infectious myocarditis.
• A proposed scheme for the pathogenesis of infectious myocarditis integrates these findings.