CLINICAL AND FUNCTIONAL ASPECTS IN MYOCARDITIC PATIENTS WITH HEART FAILURE
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14024Keywords:
myocarditis, inflammatory cardiomyopathy, fibrosis, fibroblast growth factor FGF-23, heart failure, arrhythmiasAbstract
SUMMARY. Myocarditis belongs to the group of inflammatory diseases of the heart muscle, according to the World Heart Federation and is one of the leading causes of sudden death, dilated cardiomyopathy and congestive heart failure.
The aim – to analyze the clinical manifestations of chronic myocarditis in adult patients of different age and genders, depending on the ejection fraction, and to investigate the dynamics of inflammation markers and cardiomyocyte lysis, heart failure, and their association with fibroblast growth factor FGF-23.
Material and Methods. The survey included 65 patients with chronic myocarditis who were undergoing inpatient treatment in the cardiology department and outpatient treatment in the cardiology dispensary of the Ternopil Regional Clinical Hospital during 2019-2022. Patients underwent clinical and anamnestic and laboratory and instrumental examination. Statistical processing of the research results was carried out using the created database of examined patients in the StatSoft Statistica v 10.0 program.
Results. In patients with chronic myocarditis and moderately reduced and reduced left ventricular ejection fraction (LV EF), the inflammatory syndrome manifested with an increase in ESR and fibrinogen compared to the control group. The cytolysis syndrome was evident with a significant increase in CK-MB in all groups of examined patients with chronic myocarditis, regardless of the LVEF value, and the increase in troponin T compared to the control was only significant in the group of patients with chronic myocarditis and moderately reduced and reduced LV EF. A direct significant correlation between FGF-23 and CRP (correlation coefficient r=0.410513, p=0.001) and fibrinogen (correlation coefficient r=0.462285, p=0.001) was established, confirming the role of chronic inflammatory processes in the activation of profibrotic processes in the myocardium. In patients with chronic myocarditis, a direct significant correlation of moderate strength was found between FGF-23 and NT-proBNP (correlation coefficient r=0.495400, p=0.0001), reflecting the involvement of profibrotic processes in the progression of heart failure.
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