[Morphogenesis of coronarosclerosis in rheumatism].

Post-mortem studies of 72 hearts of persons who when alive had suffered from rheumatism were carried out. A complex genesis of sclerotic processes in the vascular walls was noted. They were occurring as a result of the desorganization of the connective tissue, as well as of "wearing out" of hemodynamic adaptation structures and development of atherosclerosis. The dependence of the character of sclerotic changes in vessels upon the peculiar features of the clinical course of the disease is shown. In cases with a high activity of the rheumatic process and considerable increase in the vascular-tissue permeability the development of hyalinosis was noted, and in cases with a slow course of rheumatism an increased fibrillogenesis was observed. Simultaneously, lesion and perish of the smooth-muscle fibres of the media with outgrowth therein of the connective tissue occurred. The dependence of the extent of atherosclerosis in various branches of the coronary arteries upon a morphofunctional characteristics of this defect was established. The most extensive atherosclerotic lesions were found in those vessels which supplied with the blood the functionally burdened regions of the myocardium. A higher activity of lipolitic enzymes in the vessels and the cardiac muscle was observed in persons with rheumatism, as compared with that in persons free from cardiovascular diseases, and particularly in patients with atherosclerosis.