Morphologic and morphometric evaluation of pancreatic islets in chronic Chagas' disease

PURPOSE: Hyperglycemia and abnormal glucose tolerance tests observed in some patients with chronic Chagas' disease suggest the possibility of morphological changes in pancreatic islets and/or denervation. The purpose of this study was to describe the morphology and morphometry of pancreatic islets in chronic Chagas' disease. METHODS: Morphologic and computerized morphometric studies were performed in fragments of the head, body, and tail regions of the pancreas obtained at necropsies of 8 normal controls and 17 patients with chronic Chagas' disease: 8 with the digestive form (Megas) and 9 with the congestive heart failure form. RESULTS: The Megas group had a larger (p < 0.05) pancreatic islet area in the tail of the pancreas (10649.3 ± 4408.8 µm²) than the normal control (9481.8 ± 3242.4 µm²) and congestive heart failure (9475.1 ± 2104.9 µm²) groups; likewise, the density of the pancreatic islets (PI) was greater (1.2 ± 0.7 vs. 0.9 ± 0.6 vs. 1.9 ± 1.0 PI/mm², respectively). In the tail region of the pancreas of patients with the Megas form, there was a significant and positive correlation (r = +0.73) between the area and density of pancreatic islets. Discrete fibrosis and leukocytic infiltrates were found in pancreatic ganglia and pancreatic islets of the patients with Chagas' disease. Trypanosoma cruzi nests were not observed in the examined sections. Individuals with the Megas form of Chagas' disease showed increased area and density of pancreatic islets in the tail of the pancreas. CONCLUSION: The observed morphometric and morphologic alterations are consistent with functional changes in the pancreas, including glycemia and insulin disturbances.

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Hemodynamic effects of intravenous administration of amiodarone in congestive heart failure from chronic chagas' disease

The American Journal of Cardiology ◽

10.1016/0002-9149(83)90529-5 ◽

1983 ◽

Vol 52 (8) ◽

pp. 1046-1049 ◽

Cited By ~ 18

Author(s):

Giovanni Bellotti ◽

Lélio A. Silva ◽

Antonio Esteves Filho ◽

Miguel Rati ◽

Álvaro V. de Moraes ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Chagas Disease ◽

Intravenous Administration ◽

Hemodynamic Effects ◽

Chronic Chagas Disease

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Major Aortic Reconstruction with the Replacement of Supra-Aortic Branches: Successful Surgical Treatment of Takayasu Arteritis Initially Presented as Congestive Heart Failure

Diagnostics ◽

10.3390/diagnostics11020216 ◽

2021 ◽

Vol 11 (2) ◽

pp. 216

Author(s):

Maja Stojanovic ◽

Sanvila Raskovic ◽

Marija Boricic-Kostic ◽

Vesna Bozic ◽

Maja Vuckovic ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Takayasu Arteritis ◽

Morphological Changes ◽

Pulmonary Arteries ◽

Uneventful Recovery ◽

Severe Aortic Regurgitation ◽

Bentall Procedure ◽

One Year ◽

Arch Reconstruction

Takayasu arteritis (TA) is a rare, large vessel vasculitis that affects aorta, its major branches, and occasionally pulmonary arteries. Patients with TA can present with constitutional features and/or various symptoms and signs caused by morphological changes in the blood vessels affected by the inflammatory process. Corticosteroids (CS) and immunosuppressives (IS) are the first line treatment for active TA. Open surgery remains a treatment of choice for TA patients with moderate-to-severe aortic regurgitation (AR) and ascending aortic aneurysm (AAA). We present a 26-year-old female diagnosed with an advanced stage of TA, initially presented as congestive heart failure. Due to a progressive course of the disease (AR 3+, AAA 5.5 cm), surgery of the Aortic valve and root (Bentall procedure), with total arch reconstruction and replacement of supra-aortic branches was performed. The patient has had an uneventful recovery during the postoperative course with no complications at one year follow-up. Normal left ventricle (LV) diameter, LV ejection fraction 67%, and a trace of AR were seen on the last echocardiography.

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Morphological changes in congestive heart failure ECG

2016 2nd International Conference on Advances in Computing, Communication, & Automation (ICACCA) (Fall) ◽

10.1109/icaccaf.2016.7748993 ◽

2016 ◽

Cited By ~ 2

Author(s):

Ashish Nainwal ◽

Yatindra Kumar ◽

Bhola Jha

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Morphological Changes

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Impaired pulmonary blood flow distribution in congestive heart failure assessed using synchrotron radiation microangiography

Journal of Synchrotron Radiation ◽

10.1107/s0909049513007413 ◽

2013 ◽

Vol 20 (3) ◽

pp. 441-448 ◽

Cited By ~ 3

Author(s):

Mikiyasu Shirai ◽

Matthew Beard ◽

James T. Pearson ◽

Takashi Sonobe ◽

Hirotsugu Tsuchimochi ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Synchrotron Radiation ◽

Primary Pulmonary Hypertension ◽

Flow Distribution ◽

Vessel Density ◽

Pulmonary Vessel ◽

Pulmonary Vascular Remodeling ◽

Future Studies ◽

Functional Changes

Synchrotron radiation microangiography is a powerful tool for assessing adverse changes in pulmonary vessel density associated with primary pulmonary hypertension (PH). Congestive heart failure (CHF) leads to a `secondary' onset of PH, yet it is unknown whether secondary PH is also associated with reduced vessel density. This study utilized synchrotron radiation to assess both pulmonary vessel density and endothelial function in a Dahl rat model of CHF with secondary PH. High salt-fed Dahl salt-sensitive (Dahl-S) and salt-resistant (Dahl-R) rats were anesthetized and microangiography was performed to assess the pulmonary vessel density and vascular responses to (i) sodium nitroprusside (5.0 µg kg−1min−1), (ii) acetylcholine (3.0 µg kg−1min−1) and (iii) ET-1Areceptor blockade, BQ-123 (1 mg kg−1). Dahl-S rats developed CHF and secondary PH as evident by endothelial dysfunction, impaired vasodilatory responses to acetylcholine, enhanced vasodilatory responses to BQ-123 and extensive pulmonary vascular remodeling. Consequently, the pulmonary vessel density was adversely reduced. Interestingly, the etiology of secondary PH manifests with structural and functional changes that are comparable with that previously reported for primary PH. One important discrepancy, however, is that ET-1 modulation of pulmonary vessels is most striking in vessels with a diameter range of 100–200 µm in secondary PH, in contrast to a range of 200–300 µm in primary PH. Such discrepancies should be considered in future studies investigating primary and secondary forms of PH.

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