Object of study - alcoholic cardiomyopathy (AKMP). Purpose - to improve diagnosis AKMP based study of the clinical course of the disease, the immune reactivity of the hemostatic system, heart rate variability, morphological changes of blood cells and myocardium. Methods - clinical, laboratory, instrumental, morphological, statistical. Novelty - highlighted latent and clinically manifest stage-AKMP. It is shown the duration and number of discarded alcohol at different stages of the disease. Clinical peculiarities of latent AKMP defined transient arrhythmias, conduction and pronounced autonomic symptoms due to the effects of alcohol on the peripheral nervous system. Revealed dilatation of the heart chambers at moderately altered functional activity miokarda.Morfolohichno confirmed hipokinez infarction, dilatation of the heart chambers and reduced left ventricular ejection fraction (EF), the presence of fatty degeneration, apoptosis and dissociation of cardiomyocytes (CMC) with clinically manifest-stage disease. For the first time a comprehensive study of immune system, platelet and plasma hemostasis, heart rate variability (HRV), blood cells and ultrastructure of myocardium at different stages AKMP. Found that violations that occur in the immune system when AKMP characterized by inhibition of cellular immunity, humoral activation and killer parts, signs of apoptosis of immune cells, the severity and reversibility of which depends on the stage of the disease. Found out the state of functional activity of platelets, coagulation, fibrinolytic and anticoagulant components of the system of coagulation during AKMP. The features of the changes in the hemostatic system in different stages AKMP. Latent stage disease characterized by moderate inhibition of vascular-platelet and anticoagulant links unchanged coagulation and fibrinolytic activity of blood. Clinically manifest-stage AKMP associated with inhibition of platelet, coagulation, fibrinolytic and anticoagulant links hemostasis. First analyzed HRV in AKMP, revealed disorders of peripheral autonomic regulation of sinus rhythm, decreased protective vagal control of cardiac activity, manifested as inhibition of parasympathetic and sympathetic parts of the autonomic nervous system, regardless of stage of disease. First, using morphological (electron microscopy) techniques studied the ultrastructure of blood cells in AKMP. The criteria ultrastructural changes in blood cells AKMP. The relationship of morphological changes of immunocompetent blood cells of the immune system changes. Reveals the relationship between ultrastructural changes and inhibition of platelet hemostatic system in AKMP. Profound knowledge of the ultrastructural changes in the myocardium AKMP. The results put into practice medical institutions, scientific and educational process. Industry - medicine.
