ХАРАКТЕРИСТИКА СТРУКТУРНО-ФУНКЦІОНАЛЬНОГО СТАНУ СЕРЦЯ У ВІЙСЬКОВОСЛУЖБОВЦІВ З МІОКАРДИТОМ ЗА РЕЗУЛЬТАТАМИ 12-МІСЯЧНОГО СПОСТЕРЕЖЕННЯ

In conditions of wartime, the study of the structural and functional state of the heart in male military personnel with myocarditis has acquired particular importance in recent years. The results of such studies can expand the understanding of the clinical course of myocarditis in military personnel and can form the basis of new approaches to clinical monitoring and treatment tactics for this category of patients.The purpose of the study - to investigate dynamic changes in the structural and functional state of the heart in military personnel with myocarditis and to establish predictors of the persistence of heart failure and impaired systolic heart function.Materials and methods. The study is based on the results of a dynamic examination of 102 military personnel with acute myocarditis (AM) with reduced or mildly reduced left ventricular (LV) ejection fraction (EF). The examinations were carried out in the first month from the onset of AM symptoms before the appointment of treatment and after 6 months of observation. All patients underwent echocardiography with speckle tracking technique, cardiac magnetic resonance imaging with contrast, and the functional state of heart failure (HF) was determined using a 6-minute walk test.Results and discussion. The number of LV segments affected by inflammatory changes decreased by 42.9% (p<0.01) after 6 months of observation, and the reduction in the volume of inflammatory heart damage made the main contribution to the reduction in the total number of affected LV segments by 30.5% (p<0.01) after 6 months. This was accompanied by an increase in EF and longitudinal global systolic LV deformation by 12.8 and 24.4%, respectively (p<0.05). According to the results of the regression analysis, predictors of persistence of HF at the level of II or higher functional class after 6 months from the onset of the disease were established: LV end-diastolic volume index ≥95 ml/m2; LV ejection fraction ≤40%; LV longitudinal global systolic deformation ≤9.0%; number of LV segments with inflammatory changes ≥5 segments; the number of LV segments with delayed contrast enhancement ≥3 segments; the total number of affected segments ≥7 segments, determined during the initial examination within the 1st month from the onset of the disease.Conclusions. Based on the study of the structural and functional state of the heart in military personnel with myocarditis, predictors of normalization of left ventricular contractility 6 months after the onset of the disease were established, as well as predictors of 6-month persistence of reduced and mildly reduced left ventricular ejection fraction and factors associated with the persistence of heart failure functional class II or higher.