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  • 1
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: Partial left ventriculectomy was introduced for the treatment of refractory dilated cardiomyopathy (DCM). To determine the presence and degree of inflammatory cell infiltrates in DCM and the correlation between the underlying myocardial injury and early clinical outcomes after the operation, we performed histopathological, immunohistochemical, and virological studies of the resected myocardium. Methods: Posterolateral walls of the left ventricle from 13 idio-pathic DCM patients (9 males and 4 females; mean age = 53 ± 14 years) were examined. Qualitative and quantitative analyses of the interstitial fibrosis and of the infiltrating inflammatory cells were conducted. For the immunohistochemistry, leukocyte surface markers and antibodies to adhesion molecules and cytokines were used. The histopathological findings were compared with the clinical results, including outcome within 1 year, and pre- and postoperative hemodynamic data. Genomic analysis of the myocardium with polymerase chain reaction was performed for en-terovirus, mumps, influenza A, cytomegalovirus, and hepatitis C virus. Results: (1) The three patients who died of cardiac insufficiency after surgery had a higher count of infiltrating inflammatory cells than the eight survivors (32.1 ± 10.4 vs 16.3 ± 11.9 cells/mm2, p = 0.07). The severity of interstitial fibrosis (percent fibrosis) did not differ significantly between these two groups (28.3 f 15.0 vs 24.0 ± 11.7%). (2) In patients who died of myocardial dysfunction, focal accumulations of lymphocytes were common, in which cytotoxic/suppressor T cells and helper/inducer T cells were observed. (3) Enterovirus genome was detected in the myocardium of two patients, both of them died after surgery. Conclusions: Inflammatory cell infiltrates or active myocarditis appear in some cases to play an important role in the etiology and pathophysiology of clinically diagnosed DCM. There is a possibility that those patients with a more severe or ongoing inflammatory process might have poor outcomes after partial left ventriculectomy.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1615-2573
    Keywords: Cardiac hypertrophy ; Scanning electron microscopy ; Spontaneously hypertensive rat ; Cell steps ; Side-to-side junction ; Lateral branch
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Scanning electron microscopy was used to compare the shape, size, and connection of left ventricular (LV) myocytes between spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY) at 3, 8, 15, 35, and 63 weeks of age. For either strain at each age, five rats were studied, in which LV myocytes consisted of a cylindrical trunk with series (SB) and/ or lateral branch(es) (LB) and step formations; cell junctions had 12 common basic patterns. The length (L), width (W), and L/W ratio of the myocytes, and various indices for SB, LB, and three selected types of cell junctions were measured in 100 cells from each heart and averaged for comparison studies. In the growing period (3–8 weeks of age), the LV myocytes were similar in shape and width in the two age-matched strains and grew similarly with the same L/W ratio. In adolescent (15-week-old) WKY, LV cells grew with the same L/W ratio as in the younger rats, whereas in adolescent SHR, the cells showed a much greater increase in width than in length (disproportionate hypertrophy), the LB proliferated significantly, and the numbers of step-to-step and side-to-side junctions were diminished. In adult (15–35-week-old) WKY, LV cells continued to grow without much change in SB, LB, and the cell junctions, whereas in adult SHR, LV hypertrophy progressed with enhanced cardiomyocyte hypertrophy, increased number of SB, LB, and step-to-end junctions, and reduction in the number of step-to-step and side-to-side junctions per cell. In aged (63-week-old) WKY and SHR, the indices of LV myocytes, SB, LB, and cell junctions did not differ from those in adult WKY and SHR, except for LB thinning in the WKY and significant LB loss in the SHR. Age-related reductions in side-to-side- and step-to-step junctions, and LB loss with myocardial fibrosis in adult and aged SHR may indicate increased loss of gap junctions which couple the cells for transverse conduction, and contribute to anisotropic discontinuous propagation and potential reentrant LV arrhythmias.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1615-2573
    Keywords: Hypereosinophilic heart disease ; Endomyocardial biopsy ; Churg-Strauss syndrome ; Dilated cardiomyopathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We describe the clinical manifestations of a patient with Churg-Strauss syndrome who presented with severe acute cardiac involvement and whose disease evolved to dilated cardiomyopathy (DCM), with special reference to the histopathological findings. Endomyocardial biopsies, conducted sequentially, three times within 10 months, revealed severe eosinophilic endomyocarditis in the acute phase, interstitial fibrosis in the subacute phase, and endocardial thickening with mural thrombi, at 10 months. Although acute inflammation associated with elevation of eosinophil granule proteins subsided with steroid therapy, left ventricular dilatation with reduced contractility progressed. A subgroup of DCM is not considered to be idiopathic but, rather, an aftereffect of hypereosinophilic heart disease.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1860-1499
    Keywords: Spontaneously hypertensive rats ; Regression of left ventricular hypertrophy ; Scanning electron microscopy ; Nifedipine ; Lisinopril
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this electron microscopic study of cardiocytes during regression of left ventricular hypertrophy (LVH) in spontaneously hypertensive rats (SHR), nifedipine (SHR-N) and lisinopril (SHR-L) were given to 15-week-old SHR (SHR-C15) for 20 weeks. In untreated SHR, cardiocytes were enlarged, lateral branches (LBs) multiplied and intracellular organelles became degenerated between 15 and 35 weeks of age. In SHR-N, despite a slight reduction in blood pressure (BP), LVH regressed and cell width and the number of LBs were preserved at the level found in SHR-C15. In SHR-L, LVH regressed with moderate suppression of BP; cell width, cell length and the number of LBs reverted to those in agematched Wistar Kyoto rats. In both SHR-N and SHR-L, intracellular ultrastructures were nearly normalized. These findings suggest that, in addition to BP reduction, other pharmacological factors play a role in structural repair of hypertrophied cardiocytes.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1860-1499
    Keywords: Systemic triglyceride storage disease ; Cardiomyopathy ; Endomyocardial biopsy ; Ultrastructure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ultrastructural changes of a biopsied myocardium were observed by transmission electron microscopy in a patient with cardiomyopathy secondary to systemic triglyceride storage disease with Jordans' anomaly. There were many lipid droplets in the cardiocytes, and lipofuscin and mitochondria were increased. The volume fraction of myofibrils in the cardiocytes decreased because of an abundance of lipid droplets and mitochondriosis. Myocardial contractility may have been reduced by myofibrillar scarcity and low energy production resulting from an abnormality in the metabolism of fatty acids in the cardiocytes.
    Type of Medium: Electronic Resource
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