[A clinical case of diagnosis of left ventricular noncompaction myocardium in a patient with infectious myocarditis].

The paper describes a rare clinical case involving primary cardiomyopathy (noncompaction of the left ventricular myocardium (NCLVM), infectious myocarditis, and, possibly, hypertrophic cardiomyopathy (HCM). Objective, laboratory instrumental, invasive examination (coronarography with right ventricular endomyocardial biopsy) of the patient and histological study of his heart biopsy revealed acute infectious myocarditis concurrent with NCLVM and, possibly, HCM. The detection of a rare abnormality as NCLVM necessitates a meticulous additional examination to identify other primary cardiomyopathies (including HCM).

[Survival of patients with infectious endocarditis in various treatment methods]. / Vyzhivaemost' bol'nykh infektsionnym éndokarditom pri razlichnykh metodakh lecheniia.

The aim of the study was to compare survival of patients with infectious endocarditis (IE) by abuse of intravenous narcotic substances in conservative and combined treatment in acute IE phase. A total of 195 IE patients were examined. 121 of them was treated conservatively, 74 patients received a combined treatment including surgical one. A long-term prognosis was studied by the Kaplan-Meier method. Among drug addicts with IE, the number of survivors in the observation period in early operation in the active IE phase was significantly higher than in the conservative therapy. Long-term survival of drug addicts with IE in combined treatment was also higher: 1-2- and 3-year survival was 85.8, 76.3 and 61.0% against 64.8, 49.0 and 34.2% in conservative treatment, respectively. In non-addicts the differences were weaker: long-term survival in combined treatment was higher than in conservative one only in 5-year survival (74.1 and 41.6%, respectively).

[Echocardiography--prognosis of the course of infectious endocarditis and long-term survival in this disease]. / Ekhokardiografia - vozmozhnosti prognozirovaniia techeniia infektsionnogo éndokardita i dolgovremennoi vyzhivaemosti pri nem.

AIM: To determine prognostic opportunities of echocardiography (ECG) in infectious endocarditis (IE) basing on the assessment of microbial vegetations size and degree of valvular failure. MATERIAL AND METHODS: Of 114 patients with definite IE (72 male, 42 female), 90 ones had primary and 24 secondary endocarditis. The prospective study included all the survivors in the IE active stage--78 patients. RESULTS: Vegetations > 1 cm in size were detected in 50.8% patients, < 1 cm--in 49.2%. Hospital lethality in vegetations > 1 cm and < 1 cm was 25.8 and 16.1%, respectively. Thromboembolism rate was 81 and 64.2%, respectively. One-year survival was 78.7 and 71.4%, two-year survival 66.5 and 61.7%, three-year survival 66.5 and 49.4%, five-year survival--51.7 and 32.9% in vegetations < 1 cm and > 1 cm, respectively. Valvular regurgitation of the first degree was in 17.5%, of the second degree--in 41.9%, third-fourth degree--in 36.6% patients. Hospital lethality in mitral valve failure was 32.1%, in aortic and tricuspid failure--17.8 and 11.4%, respectively. CONCLUSION: EchoCG was most effective for predicting thromboembolism and cardiac failure. Valvular regurgitation of the third-fourth degree significantly correlates with severe cardiac failure. ECG is less informative for predicting hospital lethality.

[Infectious endocarditis of the left heart atrium in injection drug addicts]. / Infektsionnyi éndokardit klapanov levykh kamer serdtsa u in"ektsionnykh narkomanov.

AIM: To study etiology, clinical picture, course and prognosis of left heart infection endocarditis (LHIE) in drug addicts. MATERIAL AND METHODS: 61 drug addicts entered the study. 14 of them had lesions of the left heart valves (group 1), 11--of the right and left heart valves (group 2), 36--of the tricuspid valve (group 3), 39 control patients with LHIE had no addiction. Mean age in group 1 was 25.9 +/- 8.8 years, in group 4--48.3 +/- 12.6 years, p < 0.001. RESULTS: Females prevailed in group 3, males--in group 4. Splenomegaly was more frequent in the addicts. Lung lesions (abscesses and infarction) prevailed in groups 2 and 3. Cardiac failure was found more frequently in groups 1 and 4, edema--in group 3, brain affections--in groups 1 and 4. Renal damage was encountered with equal frequency in the addicts and non-addicts. The addicts had, largely, infarctions, non-addicts--glomerulonephritis. Viral hepatitis C was associated with drug addiction. Blood seedings were on the whole positive in 54%, in drug addicts--in 69%. St. aureus predominated (44%). In group 3 it was detected in 72%. It was higher than in groups 4 and 1 (p < 0.001, p < 0.01, respectively). Lethality in group 1 (57%) was higher than in group 3 (22%, p < 0.05) and group 2 (18%, p < 0.01). The leading cause of death in group 1 was cerebral thromboembolism with development of meningoencephalitis. Other causes--progressive cardiac and renal failure.