Background Programmed cell death has previously been observed in animal models of viral myocarditis and in patients with end stage dilated cardio myopathy (DCM). The purpose of the present study was to investigate ...Background Programmed cell death has previously been observed in animal models of viral myocarditis and in patients with end stage dilated cardio myopathy (DCM). The purpose of the present study was to investigate if apoptosis is also detectable in endomyocardial biopsies of patients with clinical and immuno histological signs of myocarditis. Methods Right ventricular myocardial biopsies were obtained from 53 patients with clinically suspected myocarditis (left ventricular ejection fraction 30±14%). Cardiac tissues from 4 patients with end stage heart failure were obtained during heart transplantation. Diagnosis of myocarditis and DCM was based on clinical presentation and on histological and immunohistological findings. The presence of apoptosis was investigated in paraffin embedded tissue sections by in situ end labeling of nuclear DNA strand breaks. Results By histological and immunohistological analysis 19 patients (36%) were diagnosed as myocarditis and 34 patients (64%) as DCM. Apoptosis was detected in 9 out of 19 patients with myocarditis, in 12 out of 34 patients with DCM (47% versus 35%, p=NS), and in all patients with end stage heart failure. Conclusions A high frequency of apoptosis was detectable in endomyocardial biopsies of patients with immunohistologically documented myocarditis. The rate of apoptosis in patients with myocarditis, however, was not different to patients with DCM. These findings suggest that apoptosis may be one common pathway in the pathogenesis of cardiac contractile dysfunction in patients with myocarditis and DCM.展开更多
文摘Background Programmed cell death has previously been observed in animal models of viral myocarditis and in patients with end stage dilated cardio myopathy (DCM). The purpose of the present study was to investigate if apoptosis is also detectable in endomyocardial biopsies of patients with clinical and immuno histological signs of myocarditis. Methods Right ventricular myocardial biopsies were obtained from 53 patients with clinically suspected myocarditis (left ventricular ejection fraction 30±14%). Cardiac tissues from 4 patients with end stage heart failure were obtained during heart transplantation. Diagnosis of myocarditis and DCM was based on clinical presentation and on histological and immunohistological findings. The presence of apoptosis was investigated in paraffin embedded tissue sections by in situ end labeling of nuclear DNA strand breaks. Results By histological and immunohistological analysis 19 patients (36%) were diagnosed as myocarditis and 34 patients (64%) as DCM. Apoptosis was detected in 9 out of 19 patients with myocarditis, in 12 out of 34 patients with DCM (47% versus 35%, p=NS), and in all patients with end stage heart failure. Conclusions A high frequency of apoptosis was detectable in endomyocardial biopsies of patients with immunohistologically documented myocarditis. The rate of apoptosis in patients with myocarditis, however, was not different to patients with DCM. These findings suggest that apoptosis may be one common pathway in the pathogenesis of cardiac contractile dysfunction in patients with myocarditis and DCM.
