Histopathologic, Immunohistochemical Features and Profile of Viral Antigens in Patients with Myocarditis

2015 ◽  
Vol 1085 ◽  
pp. 447-452 ◽  
Author(s):  
Yuliya Rogovskaya ◽  
Roman Botalov ◽  
Vyacheslav Ryabov
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Interstitial Fibrosis ◽  
Morphological Changes ◽  
Parvovirus B19 ◽  
Consensus Definition ◽  
Barr Virus ◽  
Epstein Barr ◽  
Group 2 ◽  
The Right

We studied medical records and endomyocardial biopsies of patients with morphological confirmed lymphocytic myocarditis. The patients were divided into two groups: 1 - patients with arrhythmias; group 2 - patients with predominance syndrome heart failure. Morphological verification of myocarditis was based on World Heart Federation Consensus definition of Inflammatory Cardiomyopathy, 1997. Immunohistological study was performed to identify antigens of cardiotrophic viruses. We revealed some features in topic and character of morphological changes in depending on clinical scenario of myocarditis. In patients with chronic heart failure due to myocarditis revealed a high incidence of expression of LMP-antigen Epstein-Barr virus, the lack of expression of adenovirus antigens. Arrhythmic presentation of myocarditis was characterized by a high frequency of expression of enteroviral VP-1 antigen and the type 1 antigen herpes virus. We were not detected expression of the VP-2 antigen parvovirus B19. As a result the most severe inflammatory changes and interstitial fibrosis of intraventricular septum, widespread damage of myocytes the severe myocardial remodeling was found in patients with presentation of myocarditis by chronic heart failure. Interstitial fibrosis of the outflow tracts of the right ventricle, the low activity of inflammation and mild fibrotic changes were feature of arrhythmic scenario of myocarditis.

Angiotensin-converting enzyme inhibition restores the diffusing capacity for carbon monoxide in patients with chronic heart failure by improving the molecular diffusion across the alveolar capillary membrane

1999 ◽  
Vol 96 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Marco GUAZZI ◽  
Piergiuseppe AGOSTONI
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibition ◽  
Angiotensin Converting Enzyme Inhibition ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibition ◽  
Group 2 ◽  
Alveolar Capillary ◽  
Group 1

Conductance of alveolar capillary membrane (DM) and capillary blood volume (VC) are the subcomponents of the pulmonary diffusing capacity for carbon monoxide (DLco). In chronic heart failure, stress failure of the membrane provides a mechanism for reduced DM and subsequent impairment of DLco. Angiotensin-converting enzyme inhibition improves DLco in patients with chronic heart failure. This study was aimed at investigating which of the two subcomponents of DLco is affected by angiotensin-converting enzyme inhibitors. Twenty-seven patients with NYHA class II to III chronic heart failure (group 1) and 13 age- and sex-matched normal subjects underwent pulmonary function testing with determination of DM and VC, while receiving placebo and 48 ;h and 1 and 2 months after starting enalapril treatment (10 ;mg twice daily). Nine similar patients (group 2) received isosorbide dinitrate (40 ;mg thrice daily) for a month then enalapril for another month, and underwent pulmonary function testing at 48 ;h and 1 month after starting treatments. Effects of angiotensin-converting enzyme inhibition in normal controls were not significant in the short- or mid-term. In group 1 patients, the only change observed at 48 ;h was a reduction in VC (probably due to a decrease in capillary pulmonary pressure). There was a marked increase in DM to a similar extent at 1 and 2 months, resulting in a significant improvement in DLco despite a decrease in VC. In group 2 patients, nitrates failed to improve DLco and DM, whereas enalapril was as effective as in group 1. These observations suggest a modulatory effect of angiotensin-converting enzyme inhibition on the membrane function which emerges gradually and persists over time and is probably dissociated from changes in pulmonary capillary pressure and VC. Chronic heart failure disturbs the alveolar capillary interface and increases gas diffusion resistance; angiotensin-converting enzyme inhibition restores the diffusive properties of the membrane and gas transfer, and protects the lung when the heart is failing.

scholarly journals Pancytopenia Secondary to SARS-CoV 2 Infection-A Case Reprt

2021 ◽  
Author(s):  
Neeraj Sharma ◽  
Rajat Shukla ◽  
Rachna Warrier ◽  
Kunal Kumar ◽  
Nalin Singh ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Blood Cells ◽  
Epstein Barr Virus ◽  
Viral Infections ◽  
Parvovirus B19 ◽  
Rare Complication ◽  
Elderly Male ◽  
Barr Virus ◽  
Immunodeficiency Virus ◽  
Epstein Barr

Abstract Pancytopenia is a condition when person has low count of all three types of blood cells causing a triage of anemia, leukopenia and thrombocytopenia. It should not be considered as a disease in itself but rather the sign of a disease that needs to be further evaluated. Among the various causes, viral infections like Human Immunodeficiency Virus, Cytomegalovirus, Epstein-Barr virus and Parvovirus B19 have been implicated. Pancytopenia is a rare complication and not commonly seen in patients with COVID 19 disease. Here, we report a case of pancytopenia in previously immunocompetent elderly male patient with SARS-CoV2 infection.

scholarly journals The risk of developing chronic heart failure in patients with hypertension depending on the actual arterial stiffness

2020 ◽  
Vol 35 (2) ◽  
pp. 98-105
Author(s):  
A. I. Chernyavina ◽  
N. A. Koziolova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Stiffness ◽  
Left Ventricular ◽  
Myocardial Mass ◽  
Developing Heart ◽  
Group 2 ◽  
Lv Volume ◽  
Lv Diastolic Function ◽  
Group 1

Objective. To determine the risk of developing chronic heart failure (CHF) in patients with hypertension (HTN) depending on the actual arterial stiffness.Material and Methods. The study included 175 patients with HTN without a verified diagnosis of heart failure. The average age was 48.5 ± 6.8 years. Patients underwent general clinical examination, volume sphygmoplethysmography assessments of cardio-ankle vascular index (CAVI), echocardiography study (left ventricular (LV) ejection fraction, LV diastolic function, LV myocardial mass index, indexed LV volume by echocardiography), and tests for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP). Patients were divided into two groups depending on CAVI. Group 1 included 141 (80.6%) patients with CAVI < 9; group 2 included 34 (19.4%) patients with CAVI > 9.Results. In patients of group 1, the level of NT-proBNP was 0.008 [0.006; 5.770], which was significantly lower than the corresponding value in group 2, where the level of NT-proBNP was 13.08 [0.01; 350.65] ng/mL (p = 0.041). Indicators of odds ratio (OR) and relative risk (RR) were also significant. The chance of developing CHF with CAVI > 9 increased by almost 7 times (OR = 6.9; 95% CI = 2.8–16.8), and OR of CHF onset was 4.1 (95% CI = 2.2–7.6). Sensitivity and specificity rates were 55.9% and 84.4%, respectively. Correlation analysis revealed a medium degree of dependence and direct relationships between NT-proBNP level and CAVI values (r = 0.35; p <0.05).Conclusion. Serum level of NT-proBNP depended on the actual arterial stiffness. Patients with CAVI > 9 indicative of an increase in true arterial stiffness had a greater risk of developing heart failure assessed based on the level of NT-proBNP in the blood. Further studies are required to assess the effects of arterial stiffness, registered within the intermediate values of CAVI index, on the risk of heart failure onset. 

scholarly journals Characteristic of infectious status in patients with acutely decompencated chronic heart failure and its impact on annual prognosis

Kardiologiia ◽  
2019 ◽  
Vol 59 (8S) ◽  
pp. 56-62
Author(s):  
V. A. Kostenko ◽  
M. Yu. Sitnikova ◽  
E. A. Skorodumova ◽  
E. G. Skorodumova ◽  
A. N. Fedorov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intestinal Bacteria ◽  
Mycoplasma Hominis ◽  
Chronic Obstructive ◽  
Infectious Agents ◽  
Gram Negative ◽  
Inflammatory Stress ◽  
Barr Virus ◽  
Epstein Barr ◽  
One Year

Aim. The assessment of infectious status in patients with acutely decompensated chronic heart faiure (ADCHF) without evident signs of acute inflammatory stress and its impact on the 1 year prognosis.Material and methods. Totally, 65 patients with ADCHF of ischemic origin investigated, age 67,3±2,3 y.o. All patients were taken markers of phagocytosis and inflammatory stress as well as antibodies to Streptococcus, Cytomegalovirus (CMV), Epstein-Barr virus (VEB), Candida albicans, Toxoplasma gondii, Aspergillus, Mycoplasma hominis and pneumonia and also level of lipopolysaccharids (LPS) of gram-negative bacteriae.Results. More often LPS of gram-negative bacteriae were revealed in patients with ADCHF and further in decreasing order – antibodies to CMV, VEB, Streptococcus, Candida, Aspergillus and LPS. All patients have been infected by at least 2 pathogens, more than 90 % of them had 3 ones or more. Mortality in first 12 months observation correlated with quantity of patient`s pathogenic patterns (r=0,52, p=0,004). Dependency of one-year mortality from degree of viral-bacterial mixt contamination was almost linear. CMV was a monopathogen with strongest correlation with mortality (r=0,39, p=0,001). In patients with more significant infection bigger rate of re-hospitalizations about new ADCHF correlated with number of pathogens was observed (r=0,61, p=0,001).Conclusion. Chronic latent infection with a significant number of pathogens is characteristic of patients with low-ejection ADCHF of ischemic genesis with a significant number of pathogens: more than 90 % of patients had three or more. The most common exogenous pathogens in the study sample of patients with chronic obstructive heart failure were CMV, EBV, and hemolytic streptococcus, of the potentially endogenous ones, gram-negative intestinal bacteria. The number of infectious agents in patients with chronic obstructive heart failure has a direct correlation with deaths and re-admission to hospital with total heart failure within 1 year after discharge from the hospital.

Myocarditis: aetiology and histopathological diagnosis

ESC CardioMed ◽  
2018 ◽  
pp. 1512-1515
Author(s):  
Sabine Pankuweit
Keyword(s):  
Parvovirus B19 ◽  
Specific Treatment ◽  
Influenza Viruses ◽  
Histopathological Diagnosis ◽  
Cardiac Tissues ◽  
Barr Virus ◽  
Reverse Transcription Pcr ◽  
Epstein Barr ◽  
Inflammatory Infiltrates ◽  
Infiltrating Lymphocytes

Although the aetiology of myocarditis in a given patient often remains unknown, a large variety of infectious agents, including viruses, bacteria, protozoa, and fungi, systemic and autoimmune diseases, drugs, and toxins can cause myocarditis. The diagnosis of myocarditis is complex and challenging. The diagnostic gold standard is endomyocardial biopsy in which myocarditis is defined using the histological Dallas criteria and immunohistochemistry. Current diagnostic criteria require more than 14 infiltrating lymphocytes/mm2 (up to 4 macrophages may be included with the presence of CD3-positive T lymphocytes ≥7 cells/mm2). Inflammatory infiltrates are subdivided into lymphocytic, eosinophilic, polymorphic, giant cell, and cardiac sarcoidosis as these diagnoses imply a specific treatment and prognosis. Molecular biological analyses of cardiac tissues should include real-time polymerase chain reaction (PCR) and reverse transcription PCR assays for the most common cardiotropic infectious viruses such as enteroviruses, adenoviruses, cytomegalovirus, influenza viruses, human herpes virus 6, Epstein–Barr virus, hepatitis C virus, and parvovirus B19.

Select Viruses in Adults

2012 ◽  
pp. 61-79
Author(s):  
Randall C. Walker
Keyword(s):  
Viral Infections ◽  
Parvovirus B19 ◽  
Systemic Disease ◽  
Diagnostic Tools ◽  
Varicella Zoster ◽  
Epidemiologic Factors ◽  
Barr Virus ◽  
Epstein Barr ◽  
Simplex Virus

The following types of viral infections are discussed in this chapter: viral infections that have the capacity for multiorgan or systemic disease; infections that affect adults who may be otherwise healthy or at least not in special populations such as herpes simplex virus (HSV) type 1, varicella-zoster virus (VZV), Epstein-Barr virus, adenovirus, mumps virus, human parvovirus B19, and coxsackievirus. Reviews of these viruses focus on differentiating clinical features, diagnostic tools and treatment, and salient microbiologic and epidemiologic factors.

scholarly journals CHRONIC HEART FAILURE CAUSES OSTEOPATHY OR IS OSTEOPATHY A FACTOR IN DEVELOPMENT OF CHRONIC HEART FAILURE?

2018 ◽  
Vol 11 (1) ◽  
pp. 111
Author(s):  
Mariya Marushchak ◽  
Inna Krynytska ◽  
Anna Mikolenko ◽  
Yurii Andreychyn ◽  
Yaroslav Bodnar
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Bone Mineralization ◽  
Stage I ◽  
Proximal Segment ◽  
Equal Proportion ◽  
Lumbar Region ◽  
Mineral Density ◽  
Functional Changes ◽  
The Right

Objective: As their proportion rises in the aging population, cardiovascular disease and osteoporosis increasingly become significant health problems of the developed world, leading to reduced lifespan and substantial financial burdens, not the least because of complications and comorbidities associated with each disorder. This study investigates bone mineralization in patients with coronary heart disease (CHD) complicated by Stage I chronic heart failure (CHF).Methods: The study group consisted of 41 patients of both sexes with CHF Stage I against the background of CHD that with no severe comorbidities that could have potentially caused changes in bone tissue. Bone mineral density was measured using dual-energy X-ray densitometry of lumbar region of spine and proximal right femur.Results: Structural and functional changes in the bone of the lumbar spine were found in 75.9% of the patients with Stage I CHF caused by CHD. Osteopenia was diagnosed in 64.4% of the patients, while osteosclerotic bone changes were less frequent and found in 11.5% of the patients. 75.8% of the patients had structural and functional changes in the proximal segment of the right femur bone. In men with Stage I CHF against the background of CHD osteopenia was more often diagnosed in the proximal segment of the right femur, while in women it was found in almost equal proportion in the spine and hip.Conclusions: In both sexes with I Stage CHF against the background of CHD were diagnosed changes in bone mineralization, with osteopenia being the prevailing diagnosis. 

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