Characteristics of heart failure course in patients
with chronic myocarditis
Hodzhakuliev B.G., Akhmedova D.M., Nazarov A.A.
ABSTRACT
The aim of this
study is to investigate the features of chronic heart failure (CHF) in patients
with chronic myocarditis (CM) in the setting of left bundle branch block
(LBBB).
Methods. To assess
the severity of CHF depending on the degree of LBBB, 51 CM
patients with signs of CHF were studied. Patients were
divided into 2 groups. The first group consisted of 21 patients (mean
age, 36.7±1.1 years) with LBBB and the second group consisted of 30 patients
(mean age, 32.5±1.0 years) without conduction disturbances. All patients
underwent resting electrocardiography and transthoracic echocardiography.
Results. As CHF
progresses, patients with LBBB have statistically significant increases in left
ventricular (LV) posterior wall and interventricular septum thickness, left
ventricular myocardial mass index (LVMMI), and left atrial (LA) size compared
to patients without conduction disturbances. End-diastolic size and
end-diastolic volume were not significantly different between groups. A more
pronounced deterioration of systolic cardiac function was
observed in group 1 patients. In patients with functional class (FC)
II CHF without LBBB, LV ejection fraction (EF) remained at the lower
limit of normal (58.9±2.3%), whereas in patients with
LBBB, LV EF decreased (47.1±1.0%). Patients in group
1 showed more pronounced signs of diastolic dysfunction at an early stage of
CHF compared to patients in group 2. Thus, the pseudonormal
type of diastolic dysfunction is diagnosed in the
majority of group 1 patients with I FC CHF and the restrictive type
in group 1 patients with II–III FC CHF.
Conclusion. Thus,
complete block of LBBB in CM patients leads to earlier cardiac remodeling
with marked impairment of myocardial systolic and diastolic functions.
Keywords: myocarditis, heart failure, left bundle branch block.
For citation:
Hodzhakuliev B.G., Akhmedova D.M., Nazarov
A.A. Characteristics of heart failure course in patients with chronic
myocarditis. International Journal of Heart and Vascular Diseases. 2024.
12(41): 22–27. DOI: 10.24412/2311-1623-2023-41-26-32