Myocyte loss in chronic heart failure

NB Rayment, AJ Haven, B Madden… - The Journal of …, 1999 - Wiley Online Library
NB Rayment, AJ Haven, B Madden, A Murday, R Trickey, M Shipley, MJ Davies, DR Katz
The Journal of Pathology, 1999Wiley Online Library
This study examined whether or not there is progressive loss of individual myocytes in
established heart failure, accounting for the progressive left ventricular dysfunction; whether
such loss is by necrosis or apoptosis; and whether such loss is more pronounced in
ischaemic heart disease or idiopathic dilated cardiomyopathy. Tissue for patients
undergoing cardiac transplantation for clinical end‐stage heart disease was used. The
clinical diagnosis was not known to the observer at the time of analysis. Indices of potential …
Abstract
This study examined whether or not there is progressive loss of individual myocytes in established heart failure, accounting for the progressive left ventricular dysfunction; whether such loss is by necrosis or apoptosis; and whether such loss is more pronounced in ischaemic heart disease or idiopathic dilated cardiomyopathy. Tissue for patients undergoing cardiac transplantation for clinical end‐stage heart disease was used. The clinical diagnosis was not known to the observer at the time of analysis. Indices of potential myocyte loss were: detection of apoptotic nuclei in situ, using the TUNEL method, immunohistochemistry for CD120a, CD120b, CD95, perforin and granzyme B; binding of C9 complex; and lipofuscin deposition within macrophages. Interstitial macrophages and T cells and their relationship to myocyte loss were also examined. There is indeed low grade myocyte loss in chronic heart failure, but there was no difference between the disease groups; rather, there was marked patient‐to‐patient variation within each category. Thus in chronic heart failure myocyte loss does occur, and both necrosis and apoptosis contribute to this loss, irrespective of the underlying nature of the disease. Any mechanism which accounts for myocyte loss must be common to both conditions, rather than specific for a pre‐operative diagnosis. Copyright © 1999 John Wiley & Sons, Ltd.
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