• Main
  • Useful links
  • Information for Contributors
  • About
  • Editorial board

  • Article
    Cherniuk S.V.


    About the author: Cherniuk S.V.
    Type of article Scentific article
    Annotation The aim of the study was to establish predictors of left ventricular systolic dysfunction and to develop the prognostic model for heart failure long-term persistence in patients with acute myocarditis. Material and methods. We performed dynamic observation of 52 patients with acute diffuse myocarditis and reduced left ventricular ejection fraction (LVEF) with II or worse heart failure (HF) functional NYHA class who underwent for immunological study (concentrations of immunoglobuline M, CD16+ and СD19+ lymphocytes, antimyocardial antibody titer, activity of blast-transformation reaction of lymphocytes), echocardiography (LVEF, LV end-diastolic and end-systolic volume indexes) and speckle tracking (longitudinal, circumferential and radial global systolic strain) as also cardiac magnetic resonance imaging. All examinations were performed 3 times: during the 1st month after the disease onset, then after 6 and 12 months of follow-up. Results. The limiting values of the indices determined in the 1st month from the debut of myocarditis have been obtained, which can serve as predictors for the presence of a reduced LV EF after 6 months: immunoglobulin M > 2.5 g/l, CD16+ > 0,32 × 109/l, titer of antibodies to the myocardium > 20.0 conv. units, and activity of blast-transformation reaction of lymphocytes > 5.9%. A mathematical model has been developed that can predict persistence of heart failure functional class at the level of II or higher after 12 months or improvement in the clinical course of myocarditis with the presence of class I or absence of HF. Sensitivity of the model is 86,2%, specificity - 83,2%, positive prognostic value - 83,2%, negative prognostic value - 72,3%. Conclusions. We established predictors of LV systolic dysfunction and developed the mathematical model for predicting heart failure in patients with acute diffuse myocarditis.
    Tags left ventricular systolic dysfunction, speckle tracking echocardiography, acute diffuse myocarditis, predictors of systolic dysfunction
    • Kovalenko VM, Lutay MI, Sirenko YUM, Sychov OS, redaktory. Sertsevo-sudynni zakhvoryuvannya: klasyfikatsiya, standarty diahnostyky ta likuvannya. Kyiv: MORION; 2016. 192 s. [in Ukrainian]
    • Kovalenko VM, Nesukay OH, Voronkov LH, Knyshov HV, Illyash MH, Ryabenko DV, Tseluyko VY, Chernyuk SV. Diahnostyka ta likuvannya miokardytu: rekomendatsiyi robochoyi hrupy z khvorob miokarda, perykarda, endokarda Asotsiatsiyi kardiolohiv Ukrayiny (proekt). Ukr. kardiol. zhurn. 2014; 3:15–21. [in Ukrainian]
    • Biestroek PS, Beek AM, Germans T, Niessen H, Van Rossum A. Diagnosis of myocarditis: current state and future perspectives. Int. J. Cardiol. 2015; 15: 191–211.
    • Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB et al. Current state of knowledge on aetiology, diagnosis, management and therapy of myocarditis: a position statement of the ESC Working group on myocardial and pericardial diseases. Eur. Heart J. 2013; 34: 2422–2436.
    • Esher F, Tschoepe C, Lassner D, Schultheiss HP. Myocarditis and inflammatory cardiomyopathy: from diagnosis to treatment. Turc. Cardiol. Dem. Ars. 2015; 43: 739–748.
    • Fung G, Luo H, Qiu Y, Yang D, McManus B. Myocarditis. Circ. Res. – 2016; 118: 496–514.
    • Heymans S. Myocarditis and heart failure: need for better diagnostic, predictive and therapeutic tools. Eur. Heart J. 2007; 28: 1279–1280.
    • Huber SA. Viral myocarditis and dilated cardiomyopathy: etiology and pathogenesis. Curr. Pharm. Des. 2016; 22: 408 – 426.
    • Lang R, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recommendations for cardiac chamber quantification in adults: an update from the American Society of echocardiography and European Asssociation of cardiovascular imaging. J. Am. Soc. Echocardiogr. 2015; 28(1): 1 – 38.
    • Magnani JW, Danic HJ, Di Salvo TG. Survival in biopsy-proven myocarditis: a long-term retrospective analysis of the histopathologic, clinical and hemodynamic predictors. Am. Heart J. 2006; 44(2): 463–470.
    • Mahrholdt H, Greuilich S. Prognosis in myocarditis J. Am. Col. Cardiol. 2017; 70: 1988–1990.
    • Maisch B, Ruppert V, Pankweit S. Management of fulminant myocarditis: a diagnosis in search of its etiology but with therapeutic options. Cur. Heart Fail. Rep. 2014; 112: 166–167.
    • Pollak A, Kontorovich A, Fuster V, Dec W. Viral myocarditis - diagnosis, treatment options, and current controversies. Nat. rev. cardiol. 2015; 12: 670–680.
    • Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats S et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 2016; 37: 2129–2200.
    • Sachedeva S, Song X, Dham N, Heath DM, De Biasi RL. Analysis of clinical parameters and cardiac magnetic resonance imaging as predictors of outcome in pediatric myocarditis. Am. J. Cardiol. 2015; 115: 499–504.
    Publication of the article «World of Medicine and Biology» №2(64), 2018 year, 093-097 pages, index UDK 616.127-002-037-073
    DOI 10.26724/2079-8334-2018-2-64-93-97