Registration Number
0218U006802,
0115U000545
, R & D reports
Title
Improvement of non-invasive diagnosis of chronic viral myocarditis
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Head
Volyanskii Аndrii Yurevich,
Registration Date
12-09-2018
Organization
The Mechnikov Research Institute of microbiology and immunology at Kharciv
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The object of the study was 87 patients with infectious myocarditis, including 44 patients with subacute (from 2 to 6 months) and 43 patients with chronic (more than 6 months) forms of infectious myocarditis, who were in Kharkiv medical institutions and 40 people, whose survey results were used as a control. Autopsy material obtained from 52 dead, including 19 from complications of infectious myocarditis, 22 from coronary diseases and 11 deaths from accidents. The aim of the study was to improve the methods of diagnosis, early prevention and treatment of myocarditis of herpesvirus nature on the basis of multiparametric analysis of markers of herpesvirus infection and immune parameters in the course of disease progression. The methods of investigation are kinetic, molecular-biological, immunological and statistical. Based on the results of the study, it was found that the pathogenic viral load, which is the presence of antigens of representatives of Herpesviridae in 87% of patients with infectious myocarditis against 100% of the presence of specific antiviral IgM and / or G, is the basis for the formation of immunological homeostasis disorders. A method is proposed that provides an increase in the frequency of detection of AH / DNA viruses of the herpes family by 3.5 to 4.5 times and enhances the quality of laboratory diagnosis of viral infections by fluorescent antibody methods and flow cytometry. It was found that the imbalance in the cytokine system in herpesviral myocarditis is a universal response of the immune system, which is characterized by an increase in the levels of proinflammatory cytokines against a background of a moderate increase in anti-inflammatory drugs. A high degree of viral load (2.9-4.5 UOP) in combination with an increase in IL-6 and IL-10 levels and a level of lymphocytes with a surface phenotype CD3 + CD95 + in more than 2.5 times with infectious myocarditis of herpesvirus nature has a high diagnostic value as an additional criterion of progress and a tendency to chronicize the course of the disease and can compete with invasive and instrumental diagnostic methods. The calculation of the integral indicator determines the personalized diagnosis of the cytokine imbalance with the possibility of determining on the basis of its therapeutic approaches and the choice of immunorehabilitation tools, and also allows to evaluate the effectiveness of selected anti-inflammatory agents for treatment of infectious herpesvirus myocarditis. The level of the integral cytokine index is more than 1.0 cu. testifies to the dysfunction of the immunological status of the examined patients and can be used as an additional diagnostic criterion for the unfavorable course of the disease with a propensity to progress, and more than 4.0 y. e. in patients with chronic course of herpesvirus myocarditis characterizes the prerequisites for the formation of heart failure. The presence in one patient of three or more representatives of the Herpesviridae family in combination with cytokine imbalance, which is accompanied by an increase in its integral index of more than 2 cu. are predictors of the development of stable cardiac arrhythmias and signs of heart failure during a three-year follow-up period. In patients with various forms of the course of herpesviral myocarditis, who received along with traditional therapy, immunomodulating and antiviral agents, significantly significant positive changes in myocardial contractility and imbalance in the cytokine system were observed. The rationale for choosing further tactics of treatment and providing recommendations aimed at improving the prognosis of the disease and improving the quality of life of patients caused by herpesvirus myocarditis requires a comprehensive survey aimed at determining the degree of viral load, the level of the integral index of cytokine imbalance and immunological mechanisms for supporting the inflammatory process in cardiomyofibrils , as well as the possible risk of complications of the course of the disease with the formation of disrupted central hemodynamics.
Product Description
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Абдуєва Ф. Е.
Волянський А. Ю.
Давиденко М. Б.
Кашпур Н. В.
Клиса А. О.
Клиса Т. Л.
Мороз М. Б.
Перемот С. Д.
Перемот Я. О.
Смілянська М. В.
Юдін І. П.
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2020-04-02
