Characteristic of the immune state and heart function in patients with diffuse myocarditis in the dynamics of the disease
Summary. Summary. The purpose of the study was to find early laboratory markers associated with the severe course of diffuse myocarditis and to study distinctive features of the immune state on different terms of the disease in accordance with the heart function. We evaluated the blood concentrations of T- and B-lymphocytes, antimyocardial antibodies (ATm), interleukin (IL)-1β, IL-10, tumor necrosis factor (TNF)-α as also blasttransformation lymphocyte activity induced by myocardium (BTLAm); by the use of 2D-echocardiography we calculated the LV ejection fraction and indexes of LV end diastolic and end systolic volume; with the help of chest X-ray we calculated the cardiothoracic index. It was established that on the first month from the disease onset diffuse myocarditis is characterized by the cell immunity activation with a high activity of proinflammatory cytokines, that was sequenced by LV remodeling and impairment of its systolic function. After 6 months we observed the reduction of immunopathologic reaction activity with switching of humoral immune response and partial recovery of LV systolic function. We detected the early laboratory markers associated with the severe course of diffuse myocarditis, they are: IL-1β, TNF-α, IL-10, ATm titer and BTLAm.
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