title: [State of the myocardial contractile structures in different areas of the heart in myocardial infarct complicated by cardiogenic shock and congestive circulatory failure].
abstract: In myocardial infarction, destructive changes develop in the contractile elements of the heart muscle in the peri-infarction zones. The degree and extent of the myofibril involvement depend on the clinical course of myocardial infarction, the drug therapy applied, and the distance from the focus of necrosis. The most marked destructive changes were in the prenecrotic zone of the myocardium in individuals with cardiogenic shock or severe congestive cardiac failure with clinical symptoms of glycoside intoxication. Gross focal contractures of myofibrils were found, which subsequently underwent fibrinoid necrosis. There were also areas of myofibril relaxation with dissociation of the actin fibers and destruction of the z-disks. The destructive changes in the myofibrils are due to a great extent to the effect of catecholamines, myocardial hypoxia, and glycoside intoxication. The disturbed orientation of the myofibril bundles in patients with recurrent myocardial infarction may play an essential role in the decrease of the myocardial contractile function and the development of extrasystolic arrhythmias.
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000150:complications* / Q000473:pathology; D009206:Myocardium / Q000648:ultrastructure*; D009336:Necrosis; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000473:pathology
vernacular_title: Sostoianie sokratitel'nykh struktur miokarda v raznykh zonakh serdtsa u bol'nykh infarktom miokarda, oslozhnennym kardiogennym shokom i zastoĭnoĭ nedostatochnost'iu krovoobrashcheniia.