Gupalo E M, Mironova N A, Rogova M M, Chumachenko P V, Tkachev G A, Naumova M A, Narusov O Iu, Gerasimova V V, Bakalov S A, Samko A M, Buriachkovskaia L I, Tereshchenko S N, Golitsyn S P
Kardiologiia. 2014;54(5):8-15. doi: 10.18565/cardio.2014.5.8-15.
In 22 patients with heart failure and/or ventricular arrhythmias presumably of inflammatory etiology the results of clinical and instrumental investigation were analyzed and compared to the endomyocardial biopsy data. In the subgroup of patients with left bundle branch block (LBBB) we revealed features indicative of lesser contribution of inflammatory destruction in pathogenesis of cardiomyopathy. The only virus, detected in biopsy samples, was parvovirus B19. Its persistence in myocardium was not related to activity of inflammation and severity of clinical course. Increased expression of Coxsackie adenovirus receptor (CAR) was found in 20 patients. It was not related to inflammatory cells infiltration and virus persistence in myocardium. Patients with most prominent CAR expression were characteried by right heart dilatation, more severe heart failure and absence of LBBB. Enhancement of CAR expression could reflect the attempt of organism to repair intercellular communications between cardiomyocites and to protect cells from the products of necrotic lysis during long standing inflammation.
在22例推测病因是炎症性的心力衰竭和/或室性心律失常患者中,分析了临床和器械检查结果,并与心内膜心肌活检数据进行了比较。在左束支传导阻滞(LBBB)患者亚组中,我们发现了一些特征,表明炎症破坏在心肌病发病机制中的作用较小。活检样本中检测到的唯一病毒是细小病毒B19。其在心肌中的持续存在与炎症活动和临床病程严重程度无关。在20例患者中发现柯萨奇腺病毒受体(CAR)表达增加。它与心肌中的炎症细胞浸润和病毒持续存在无关。CAR表达最明显的患者表现为右心扩张、更严重的心力衰竭且无LBBB。CAR表达增强可能反映了机体在长期炎症过程中修复心肌细胞间通讯以及保护细胞免受坏死溶解产物影响的尝试。