NEW PATHOGENIC MECHANISMS OF THE CHRONIC PERICARDITIS
https://doi.org/10.20996/1819-6446-2009-5-2-49-54
Abstract
Aim. To determine the main mechanisms of chronic pericarditis (CP) on the basis of chronic pericardium inflammation study with morphological, laboratory and instrumental methods.
Material and methods. 139 patients with CP were involved in the study. The analysis of clinical data, results of laboratory and instrumental examination as well as morphological data of 27 pericardectomies was performed.
Results. The morphological features in 92,5% of cases did not depend on disease aetiology. Inflammation signs are founded in 74,1% of pericardium samples. Inflammatory reaction of adjacent fatty tissue and changes of the pericardium nervous system also was revealed. The levels of immune status markers in patients with CP significantly depended on inflammation activity and they did not depend on disease causes. Anti-inflammatory cytokine levels (receptor antagonist of IL-1 alpha (RAIL-1 alpha) above 700 pg/ml is founded in patients with subclinical disease feature. RAIL level below 300 pg/ml took place in serious and recurring CP.
Conclusion. CP is a result of pericardium inflammation with involving adjacent fatty tissue and with changes of the pericardium nervous system. Relationship between disease clinical course and RAIL-1 level was found. CP progression and new pathogenesis mechanisms is discussed.
About the Authors
V. V. KochmashevaRussian Federation
E. D. Rozhdestvenskaya
Russian Federation
E. S. Belikov
Russian Federation
M. A. Dergunova
Russian Federation
M. V. Arhipov
Russian Federation
References
1. Европейские рекомендации по диагностике и лечению заболеваний перикарда: методические рекомендации. Часть 1. Доказательная кардиология 2004;(3):19-32.
2. Maisch B., Ristić A.D. The classification of pericardial disease in the age of modern medicine. Curr Cardiol Rep 2002;4(1):13-21.
3. Мравян С.Р., Гуревич М.А. Клиника, диагностика и лечение острых и рецидивирующих перикардитов. Российский медицинский журнал 2007;(3):49-52.
4. Leclair F., Gueffet J.P., Baron O., et al. A chronic pericardial effusion [in French]. Ann Pathol 2005;25(2):143-4.
5. Maisch B. Recurrent pericarditis: mysterious or not so mysterious? Eur Heart J 2005;26(7):631-3.
6. Imazio M., Demichelis B., Parrini I., et al. Management, risk factors, and outcomes in recurrent pericarditis. Am J Cardiol 2005;96(5):736-9.
7. Maisch В., Maisch S., Kochsiek K. Immune reactions in tuberculous and chronic constrictive pericarditis. Clinical data and diagnostic significance of antimyocardial antibodies. Am J Cardiol 1982;50(5):1007-13.
8. Европейские рекомендации по диагностике и лечению заболеваний перикарда: методические рекомендации. Часть 2. Доказательная кардиология 2004;(4):19-35.
9. Talreja D.R., Edwards W.D., Danielson G.K., et al. Constrictive pericarditis in 26 patients with histologically normal pericardial thickness. Circulation 2003;108(15):1852-7.
10. Fairweather D., Frisancho-Kiss S., Yusung S.A. et al. Interferon-gamma protects against chronic viral myocarditis by reducing mast cell degranulation, fibrosis, and the profibrotic cytokines transforming growth factorbeta 1, interleukin-1 beta, and interleukin-4 in the heart. Am J Pathol 2004;165(6):1883-94.
11. de Souza A.L., Marques Salgado M., Romano C.C. et al. Cytokine activation in purulent pericarditis caused by Neisseria meningitidis serogroup C. Int J Cardiol 2006;113(3):419-21.
12. Li Z.C., Li X.P. Etiological diagnosis of the patients with pericarditis after pericardiectomy [in Chinese]. Hunan Yi Ke Da Xue Xue Bao 2003;28(2):155-8.
13. Rachmawati K., Handayani A., Shatri H., et al. Constrictive pericarditis. Acta Med. Indones 2004;36(1):42.
14. Isaacs D., Stark P., Nichols C., et al. Post-traumatic pericardial calcification. J Thorac Imaging 2003;18(4):250-3.
15. Шевченко Ю.Л., Кучеренко А.Д. Перикардит: Лечение, диагностика, профилактика. СПб.: Наука; 1999.
Review
For citations:
Kochmasheva V.V., Rozhdestvenskaya E.D., Belikov E.S., Dergunova M.A., Arhipov M.V. NEW PATHOGENIC MECHANISMS OF THE CHRONIC PERICARDITIS. Rational Pharmacotherapy in Cardiology. 2009;5(2):49-54. (In Russ.) https://doi.org/10.20996/1819-6446-2009-5-2-49-54
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