Histopathological and Immunological Characteristics of Tachycardia-Induced Cardiomyopathy

Tachycardiomyopathy or tachycardia-induced cardiomyopathy (TCM) has been known for decades as a reversible form of nonischemic cardiomyopathy. However, its mechanism and properties remain poorly understood. The current study investigated endomyocardial biopsy samples from patients with TCM and compa...

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Vydáno v:Journal of the American College of Cardiology Ročník 69; číslo 17; s. 2160
Hlavní autoři: Mueller, Karin A L, Heinzmann, David, Klingel, Karin, Fallier-Becker, Petra, Kandolf, Reinhard, Kilias, Antonios, Walker-Allgaier, Britta, Borst, Oliver, Kumbrink, Jörg, Kirchner, Thomas, Langer, Harald, Geisler, Tobias, Schreieck, Jürgen, Gramlich, Michael, Gawaz, Meinrad, Seizer, Peter
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 02.05.2017
Témata:
Adult
Aged
Cardiomyopathies - immunology
Cardiomyopathies - metabolism
Cardiomyopathies - pathology
Female
Humans
Macrophages
Male
Middle Aged
Mitochondria
Myocardium - metabolism
Myocardium - pathology
Retrospective Studies
RNA, Messenger - metabolism
Tachycardia - complications
Tachycardia - metabolism
endomyocardial biopsy
heart failure
arrhythmia-induced cardiomyopathy
mitochondria
ISSN:1558-3597, 1558-3597
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Shrnutí:Tachycardiomyopathy or tachycardia-induced cardiomyopathy (TCM) has been known for decades as a reversible form of nonischemic cardiomyopathy. However, its mechanism and properties remain poorly understood. The current study investigated endomyocardial biopsy samples from patients with TCM and compared them with samples from patients with dilated cardiomyopathy (DCM) and inflammatory cardiomyopathy (ICM). The study included 189 patients with new-onset heart failure and severely reduced ejection fraction not caused by valvular or ischemic heart disease. Nineteen patients retrospectively fulfilled common criteria of TCM, 79 patients had a diagnosis of DCM, and 91 had a diagnosis of ICM. Patients with TCM, on the basis of clinical criteria, had stronger myocardial expression of major histocompatibility complex class II molecule and enhanced infiltration of CD68 macrophages compared with patients with DCM. Furthermore, when compared with patients with ICM, the presence of T cells and macrophages was significantly reduced in TCM. Myocardial fibrosis was detected to a significantly lower degree in patients with TCM compared with patients with DCM and ICM. Electron microscopic examination revealed severe structural changes in patients with TCM. A disturbed distribution pattern of mitochondria was predominantly present in TCM. Quantitative assessment of myocyte morphology revealed significantly enhanced myocyte size compared with patients with ICM. Ribonucleic acid expression analysis identified changes in metabolic pathways among the patient groups. TCM is characterized by changes in cardiomyocyte and mitochondrial morphology accompanied by a macrophage-dominated cardiac inflammation. Thus, further prospective studies are warranted to characterize patients with TCM by endomyocardial biopsy more clearly.
Bibliografie:ObjectType-Article-1
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ISSN:1558-3597
1558-3597
DOI:10.1016/j.jacc.2017.02.049