Inflammatory and dilated cardiomyopathies: morphofunctional similarities for ambivalent entities
Keywords:
cardiomyopathy, coronaroventriculography, subendomyocardial biopsy, cardiomyocyte, heart failureAbstract
To analyze tissue and degenerative myocardial changes in relation to intracardiac hemodynamics and coronary circulation in patients with inflammatory cardiomyopathy (ICMP) and dilated cardiomyopathy (DCMP). 150 patients with FC I-IV NYHA heart failure were investigated: 75 with DCMP (35.6±1.3), 75 with ICMP (38.5±1.4). Coronary angiography, subendomyocardial biopsy, immunohistochemical analysis, and myocardial scintigraphy were performed. Morpho-functional analysis of intramyocardial and coronary circulation in investigated patients shows reduced epicardial coronary tone, arteriolar functional strictures, and decreased capillary filling. Scintigraphy detects myocardial perfusion defects with the same occurrence (36.0%) among patients and an 80% incidence of concordance between perfusion defects and areas of affected myocardial contractility. Morphometrically there are nuclei with increased size and mitochondrial surface area over 50% of the myocyte area. Electrophoresis shows a low total CrKmit fraction, 12.85, and an increased MB, 27.24, compared to the compensated myocardium, 21.08 and 19.7 respectively. Tissue metabolism is significantly decreased in all investigated patients. Data of morphofunctional, immunohistochemical and cardiomyocyte metabolism investigation reveal indistinct elements for both nosological entities and indicate the possibility of evolutionary transformation of inflammatory cardiomyopathies into dilated cardiomyopathies, which is also supported by intramyocardial circulation, intracardiac hemodynamic and regional myocardial contractility parameters.
References
1. Amsallem E., Kasparian C., Haddour G., Boissel P., Nony P. Phosphodiesterase III inhibitors for heart failure (Review). Cochrane Database of Systematic Reviews. 2005, 1, nr. CD002230. https://doi.org/10.1002/14651858.CD002230.pub2
2. Martin N, Manoharan K, Thomas J, Davies C, Lumbers RT. Beta-blockers and inhibitors of the reninangiotensin aldosterone system for chronic heart failure with preserved ejection fraction. Cochrane Database of Systematic Reviews. 2018, Issue 6. Art. No.: CD012721. DOI: 10.1002/14651858.CD012721. pub2. Fisher A, Doree C, Mathur A, Taggart P, Martin-Rendon E. Stem cell therapy for chronic ischaemic heart disease and congestive heart failure (Review). Cochrane Database of Systematic Reviews. 2016, Issue 12. Art. No.: CD007888. https://doi.org/10.1002/14651858.CD007888.pub3
4. Long L, Mordi R, Bridges C, Sagar A, Davies J, Coats S, Dalal H, Rees K, Singh J, Taylor RS. Exercise-based cardiac rehabilitation for adults with heart failure (Review). Cochrane Database of Systematic Reviews. 2019, Issue 1. Art. No.: CD003331. https://doi.org/10.1002/14651858.CD003331.pub5
5. Madmani M., Solaiman A., Agha K., Madmani Y., Shahrour Y., Essali A., Kadro W. Coenzyme Q10 for heart failure (Review). Cochrane Database of Systematic Reviews. 2014, 6, Art. No. CD008684. https://doi.org/10.1002/14651858.CD008684.pub2
6. Heran BS, Musini VM, Bassett K, Taylor RS, Wright JM. Angiotensin receptor blockers for heart failure. Cochrane Database of Systematic Reviews. 2012, Issue 4. Art. No.: CD003040. CD003040.pub2. https://doi.org/10.1002/14651858
7. G. Weintraub, C. Semsarian, P. Macdonald. Dilated cardiomyopathy. The Lancet. 2017, vol. 330, 400-414. 10082 https://doi.org/10.1016/S0140-6736(16)31713-5
8. K. Karatolios, V. Holzendorf, G. Hatzis et al., "Clinical predictors of outcome in patients with inflammatory dilated cardiomyopathy," PLoS One, vol. 12, no. 12, p. e0188491, 2017. https://doi.org/10.1371/journal.pone.0188491
9. Yancy CW, Jessup M, Bozkurt B, et al. 2016 ACC/AHA/ HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/ AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol. 2016;68(13):1476-1488. https://doi.org/10.1016/j.jacc.2016.05.011
10. Pollack A, Kontorovich AR, Fuster V, Dec GW. Viral myocarditis--diagnosis, treatment options, and current controversies. Nat Rev Cardiol. 2015; 12: 670-680. Ref.: http://bit.ly/323VPZ5 https://doi.org/10.1038/nrcardio.2015.108
11. Bracamonte-Baran W, Čiháková D. Cardiac Autoimmunity: Myocarditis. Adv Exp Med Biol. 2017; 1003: 187-221. Ref.: http://bit.ly/2RMeJ1U https://doi.org/10.1007/978-3-319-57613-8_10
12. Schultheiss HP, Fairweather D, Caforio ALP, Escher F, Hershberger RE, et al. Dilated cardiomyopathy. Nat Rev Dis Primers. 2019; 5: 32. Ref.: http://bit.ly/2XktA9O https://doi.org/10.1038/s41572-019-0084-1
13. Carsten Tschöpe , Enrico Ammirati, Biykem Bozkurt., et al. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions, Circ Res.2019;124:1568-1583. https://doi.org/10.1161/CIRCRESAHA.118.313578
14. C. Hjalmarsson, J.-Å. Liljeqvist, M. Lindh et al., "Parvovirus B19 in endomyocardial biopsy of patients with idiopathic dilated cardiomyopathy: foe or bystander?" Journal of Cardiac Failure, vol. 25, no. 1, pp. 60-63, 2019. https://doi.org/10.1016/j.cardfail.2018.07.466
15. Distefano G., Standley RA., Zhang X., et al. Physical activity unveils the relationship between mitochondrial energetics, muscle quality, and physical function in older adults.J Cachexia Sarcopenia Muscle. 2018 Apr;9(2):279-294. https://doi.org/10.1002/jcsm.12272
16. Gonzalez-Freire M1, Scalzo P1, D'Agostino J., et al. Skeletal muscle ex vivo mitochondrial respiration parallels decline in vivo oxidative capacity, cardiorespiratory fitness, and muscle strength: The Baltimore Long
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
