[Etiopathogenesis of dilated cardiomyopathies].
This study was carried out on 43 patients affected by dilated cardiomyopathy to investigate some of the etiopathological hypotheses on this illness. The Authors investigated: the persistence of virus genoma (coxsackie, HBV) on endomyocardial biopsies; the pattern of the II class major histocompatibility complex (MHC) were in the blood lymphocytes; the microvascular aspect of coronary circulation in the endomyocardial biopsies. Finally, in a separated group of 19 patients, the microvascular circulation was studied on skin biopsies and correlated with diabetic, valvular and normal subject. The results showed a 14% positivity for the presence of the virus genoma and a significant predominate of DR5 in the II class MHC of patients with a worse ventricular function. Capillary vessels of the coronary microcirculation were dilated in the 48% of the patients, especially in more compromised subjects. Viral myocarditis seem to play a role in the etiopathogenesis of dilated cardiomyopathies (DCM) and the pattern of MHC could influence the progression of the illness. The microcirculation is probably a pathophysiological aspect. No etiological hypothesis seems to predominate.
Istituto di Cardiologia, Università degli Studi, Pisa.
A S
AS
Petronio
M T
MT
Manes
F
F
Di Meco
V
V
Nardini
F
F
Pecori
L
L
Ceccherini-Nellis
A
A
Barsotti
M
M
Mariani
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D005260:Female; D006321:Heart / Q000382:microbiology; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged
Eziopatogenesi delle cardiomiopatie dilatative.