CHALLENGES IN THE MORPHO-FUNCTIONAL CHARACTERIZATION OF DILATED CARDIOMYOPATHY

T. BRANISTE; Gh. BRANISTE; V. DORGAN

T. BRANISTE “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau
Gh. BRANISTE State University of Physical Education and Sport, Chisinau
V. DORGAN State University of Physical Education and Sport, Chisinau

Abstract

Aim refining the diagnosis of dilated cardiomyopathy (DCM) and improving diagnostic criteria. Material and methods: The study group consisted of 655 patients with heart failure (HF), NYHA class I-IV, of which 358 patients with DCM, 87 patients with inflammatory cardiomyopathy (ICM) and 210 patients with ischemic cardiopathy/ischemic cardiomyopathy (ICP/ICMP).The control group consisted of 120 healthy individuals. The diagnostics of DCM, ICM and ICP/ICMP comply with the recommendations of the current guidelines. Results: The radiopaque ventriculography showed increased ventricular volume, diffuse decrease of myocardial contractility and low ejection fraction of the left ventricle (LV). Perfusion abnormalities recorded in DCM patients (36.2%) did not differ significantly from those recorded in ICM (34.8%) and ICP/ICMP patients (40.3%). Holter monitoring revealed electrical instability of the myocardium in DCM and ICM patients, without statistically significant differences. Mitochondrial respiration study in DCM patients revealed a lower mean content of creatinekinase-15 and a greater content of creatinkinase MB-27 compared to healthy control group, and a marked impairment in acceptor control and creatine-stimulated mitochondrial respiration. The levels of myosin light chain kinase and related protein kinase in DCM and ICM were increased by 70% and 52%, respectively. We also have noticed a significant increase in annexin V and annexin VI levels in the myocardium of DCM patients compared to healthy control group: 122 ± 5% (p <0.05) and 119 ± 5% (p <0.05), respectively. Conclusions: We have conducted a complex cardio-vascular evaluation, using modern, high sensitivity and specificity techniques, with the purpose of identifying functional and structural elements, which will allow us to refine the DCM diagnostic. The results of our study grant a better understanding of the electrical and mechanical phenomena that underlie the functional and structural changes encountered in DCM. We thoroughly evaluated a series of morphological, morphometric and bioenergetic parameters of the myocardium, we determined intracardiac hemodynamic parameters and quantified the contractile status of the heart. Although we have identified significant morpho functional abnormalities, we have concluded that they have no specificity for DCM. These changes may rather be considered the expression of advanced disease status.

Author Biographies

T. BRANISTE, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau

Faculty of Medicine
Clinic of Medical Semiology

Gh. BRANISTE, State University of Physical Education and Sport, Chisinau

The Theoretical Bases of Physical Culture

V. DORGAN, State University of Physical Education and Sport, Chisinau

The Theoretical Bases of Physical Culture

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