scholarly journals Homeostasis Regulating Factors, Innervation, Ischemia and Inflammatory Markers in the Right Atrial Tissue from Patients with Degenerative Aortic Valve Stenosis and Coronary Heart Disease

2021 ◽  
Vol 75 (3) ◽  
pp. 186-193
Author(s):  
Edīte Vārtiņa ◽  
Māra Pilmane ◽  
Romāns Lācis
Keyword(s):  
Coronary Heart Disease ◽  
Endothelial Cells ◽  
Heart Disease ◽  
Inflammatory Markers ◽  
Chromogranin A ◽  
Right Atrial ◽  
Pgp 9.5 ◽  
Atrial Tissue ◽  
Endocardial Endothelial Cells ◽  
The Right

Abstract Both coronary heart disease (CHD) and degenerative aortic valve (AoV) stenosis have common risk factors, such as age, high blood cholesterol, diabetes, smoking, high blood pressure, inflammation, and metabolic syndrome. However, these diseases are not always observed together, confirming the existence of risk and pathogenesis factors specific to each disease. The aim of this study was to identify presence and distribution of common and different homeostasis regulating factors, innervation, ischemia and inflammatory markers in the right atrial tissue from patients with degenerative AoV stenosis and CHD. During elective cardiac surgery, right atrial tissue fragments were taken from 20 patients with CHD and from 9 patients with degenerative AoV stenosis. All tissue fragments were stained for immunohistochemical detection of protein-gene peptide 9.5 (PGP 9.5), atrial natriuretic peptide (ANUP), vascular endothelial growth factor (VEGF), chromogranin A, endothelin, interleukin 1 and 10 (Il-1 and Il-10) and β defensins 2, and 3 (βD2 and βD3). For the quantification of structures, a semi-quantitative counting method was used. Mostly numerous Il-10 positive cardiomyocytes and epi-/endocardial endothelial cells were detected in all specimens taken from patients with CHD, and statistically more than in specimens taken from patients with degenerative AoV disease (p = 0.007 and p = 0.016). Also, the number of βD3 positive cardiomyocytes was higher in the coronary heart disease group (p = 0.026). All other tested markers such as PGP 9.5, ANUP, VEGF, endothelin, chromogranin A, Il-1 and βD2 showed similar expression in both groups. Increased production of ANUP in right atrial tissue characterises both CHD and degenerative AoV stenosis. Production of ChgA in right atrial endocardial endothelial cells might represent regulation of sympathetic activity as a compensatory homeostatic response. Increased PGP 9.5-containing innervation is characteristic in patients with degenerative AoV disease and secondary mitral insufficiency. A stable increase of VEGF and variations of endothelin without statistically significant difference suggest influence of ischemia on the local vascular blood supply. Decreased production of Il-1α together with moderate to rich production of Il-10, βD2, and βD3 indicates the dominance of the local immune system over inflammation.

scholarly journals Right Atrial Morphology in Coronary Heart Disease and Degenerative Aortic Valve Stenosis. Summary of the Doctoral Thesis

2021 ◽  
Author(s):  
◽  
Edīte Vārtiņa
Keyword(s):  
Coronary Heart Disease ◽  
Congenital Heart Disease ◽  
Endothelial Cells ◽  
Heart Disease ◽  
Aortic Valve ◽  
Congenital Heart ◽  
Right Atrial ◽  
Atrial Tissue ◽  
Endocardial Endothelial Cells ◽  
The Right

One of the main forms of cardiovascular diseases is coronary heart disease (CHD) but degenerative aortic valve (AoV) stenosis is the most frequent native valve disease. Both CHD and degenerative AoV stenosis have common risk factors such as age, high blood cholesterol, diabetes, smoking, high blood pressure, inflammation, and metabolic syndrome. Not only risk factors, but also pathophysiological changes, especially in the early stages of degenerative aortic valve stenosis, are similar to atherosclerosis - endothelial damage, lipid deposition, focal sclerosis, inflammatory cell infiltration, cytokine release and calcification. However, these conditions are not always observed at the same time. This confirms the existence of risk and pathogenesis factors specific to each disease. Although these heart diseases have been known for a long time and are intensively studied, there is still a lack of reliable markers that could help predict disease progression, the need for further surgery and mortality, therefore the pathophysiological processes involved in disease pathogenesis should be re-evaluated. Tissue changes in these diseases are complex and include cell death, cardiac innervation, tissue ischemia, regulators of metabolism and homeostasis, markers of inflammation and anti-inflammation, and other changes that are still not fully understood. Aim of the study: to determine the prevalence of markers of apoptosis, homeostasis regulating factors, innervation, ischemia and inflammation in right atrial tissue in cases of coronary heart disease and degenerative aortic valve stenosis. The tissue material used in the study – fragments of the right atrial appendage collected during elective open heart surgeries. A total of 36 patients with acquired heart diseases were included in the study – 24 patients with coronary heart disease and 12 patients with degenerative aortic valve stenosis. Samples of right atrial tissue from 5 patients with congenital heart disease operated at an early age were used as the study control group. Tissues were stained with hematoxylin and eosin for routine light microscopy, treated with the biotin-streptovidine method for immunohistochemical detection of tissue markers and by the TUNEL method for the detection of apoptotic cells. The following markers were identified in right atrial tissue by immunohistochemistry: atrial natriuretic peptide (ANUP), PGP 9.5- containing innervation, vascular endothelial growth factor (VEGF), chromogranin A (ChgA), endothelin 1 (ET-1), interleukin 1α (Il-1α ), interleukin 10 (II-10), β defensins 2, 3 and 4 (βD2, βD3 and βD4, respectively). Right atrial tissue in both CHD and degenerative AoV stenosis is characterized by non-specific degenerative morphological changes – pronounced vacuolization as well as changes in the shape and size of cardiomyocytes and their nuclei. In addition, these patients have a high proportion of apoptotic cardiomyocytes. Although there were no significant lesions in the coronary arteries in patients with AoV stenosis, connective tissue ingrowth and vascular sclerosis were observed in some patients in both groups. In the case of CHD and degenerative AoV stenosis, activation of the right atrial endocardial endothelial cells occurs, characterized by a change of shape from flat to cubic and rich release of ChgA, ET-1, Il-1α, Il-10, βD2 and βD3. Patients with CHD and AoV stenosis in the right atrial tissue had statistically significant higher numbers of ANUP-positive cardiomyocytes, all types of IL-10 positive cells and βD2 and βD3-positive endocardial endothelial cells, but fewer ChgA-positive cells than controls or patients with congenital heart disease. Thus, in both cases of acquired heart disease, an anti-inflammatory response prevails in the right atrial tissue, but increased activity of the neuroendocrine system is more common in patients with congenital heart disease at an early age. Although some tendencies were observed, for example, in the CHD group, there were slightly more VEGF, ET-1, Il-1α positive endocardial endothelial cells, Il-10 positive cardiomyocytes, connective tissue and endothelial cells, but in AoV stenosis group, there were slightly more ChgA-positive endocardial endothelial cells, however, these differences did not reach statistical significance. The most striking finding in our study was the rich expression of antimicrobial peptides, such as human β defensins 2 and 3, in the right atrial tissues in patients with CHD, degenerative AoV stenosis and congenital heart disease.

scholarly journals P1498 Right atrial thrombus in a young septic patient with lymphoma

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Habjan ◽  
B Erzen ◽  
M Miklic ◽  
A Skarlovnik
Keyword(s):  
Staphylococcus Aureus ◽  
Right Atrium ◽  
Inflammatory Markers ◽  
Clinical Status ◽  
Left Knee ◽  
Blood Cultures ◽  
Right Atrial ◽  
Atrial Thrombus ◽  
The Right ◽  
And Staphylococcus Aureus

Abstract Background Catheter-related right atrial thrombosis is a rare, but potentially life threatening complication in patients with central venous catheters (CVCs). Echocardiography is an indispensable tool in the diagnosis of right atrial thrombosis. We present a case of a young man with lymphoma, Staphylococcus aureus sepsis and a peripherally inserted central catheter (PICC) who had a septic thrombus in the right atrium. Case summary A 23-year-old male patient with recently diagnosed Hodgkin’s lymphoma had an inserted PICC for the purpose of chemotherapy application. Three days after the first chemotherapy application a thrombosis of the cephalic and subclavian veins at the site of PICC was found. The PICC was removed and the patient was treated with therapeutic doses of dalteparin. A day after the discovery of thrombosis, the patient became clinically septic, with high inflammatory markers and Staphylococcus aureus was isolated from his blood cultures. He was promptly treated with flucloxacillin. Due to pain in his left knee, a knee puncture was performed, and Staphylococcus aureus was isolated also from the knee synovial fluid. A transthoracic echocardiography revealed a 2.8 x 2.8 cm sessile thrombus on the lateral wall of the right atrium. There were no vegetations on the tricuspid or other valves. Due to increasing pain in his left knee and an increase in inflammatory markers a synovectomy was performed. After the operation the clinical status improved and the inflammatory parameters decreased. A magnetic resonance imaging of the heart was performed, which confirmed the thrombus described by echocardiography and excluded the presence of abscesses. All the time the patient was treated in the intensive care unit with standard heparin, flucloxacillin, and piperacillin/tazobactam due to neutropenia. The inflammatory markers slowly decreased and all further blood cultures were negative. Follow-up echocardiography after 16 days of antibiotic and anticoagulant therapy revealed that the mass in the right atrium, attached on the lateral atrium wall, was slightly smaller than before. The mass was centrally un-echogenic with echogenic cover, appearing as a partial regression of the septic thrombus with a central colliquation. The heart valves remained free of vegetations. There was a minor pericardial effusion, with no signs of constriction. Due to improved clinical status the patient was able to start with chemotherapy again after a pause of three weeks. Conclusion The patient had three important risk factors for thrombosis: PICC, sepsis and malignancy. Echocardiography is an important tool for mass diagnosis and the exclusion of vegetations in a septic patient. Often there is a need for further specification of the mass etiology or for the exclusion of other pathology, like abscesses in our case. Magnetic resonance is an important tool that can complement the echocardiographic examination. Abstract P1498 Figure. Right atrial thrombus

P-055 The circulating endothelial cells level and coronary heart disease in women

2013 ◽  
Vol 131 ◽  
pp. S91
Author(s):  
O. Sirotkina ◽  
V. Feoktistova ◽  
A. Laskovets ◽  
I. Leonova ◽  
L. Gaykovaya ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Endothelial Cells ◽  
Heart Disease ◽  
Circulating Endothelial Cells

Polymorphisms in the P-selectin (CD62P) and P-selectin glycoprotein ligand-1 (PSGL-1) genes and coronary heart disease

2004 ◽  
Vol 42 (9) ◽  
Author(s):  
Peter Bugert ◽  
Marion Vosberg ◽  
Mathias Entelmann ◽  
Jürgen Jahn ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Endothelial Cells ◽  
Heart Disease ◽  
Cell Adhesion ◽  
Adhesion Molecules ◽  
Cell Adhesion Molecules ◽  
Coding Regions

AbstractP-selectin and its ligand, PSGL-1, are cell adhesion molecules that facilitate interaction of platelets, leukocytes and endothelial cells. Polymorphisms of these genes have been reported to be associated with coronary heart disease (CHD). In the present study, we characterized the entire coding regions of

scholarly journals THE EFFECT OF GHRELIN ON INFLAMMATORY MARKERS IN APNEIC PATIENTS WITH/WITHOUT CORONARY HEART DISEASE

Heart ◽  
2012 ◽  
Vol 98 (Suppl 2) ◽  
pp. E313.1-E313
Author(s):  
Dan Yang ◽  
Zhihong Liu ◽  
Qin Luo ◽  
Zhihong Liu
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Inflammatory Markers

scholarly journals Vitamin A reserve of liver in health and coronary heart disease among ethnic groups in Singapore

1988 ◽  
Vol 60 (3) ◽  
pp. 407-412 ◽  
Author(s):  
N. Saha ◽  
T. B. Ng ◽  
P. Y. Tan ◽  
K. P. Wee
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Vitamin A ◽  
Ethnic Groups ◽  
Liver Tissue ◽  
Human Liver ◽  
Human Liver Tissue ◽  
Significant Difference ◽  
The Right ◽  
Ethnic Distribution

1. The vitamin A content of human liver tissue was determined in 363 autopsy samples. The sample comprised a total of 181 subjects dying after accidents and 182 dying from coronary heart disease among Singapore ethnic groups of both sexes.2. The medium vitamin A reserve was 146 mg/kg in accident victims and 141 mg/kg in those who had died of coronary heart disease. Of all the samples 16% contained less than 40 mg/kg, 45% had 100–300 mg/kg, while 9% contained more than 500 mg/kg liver.3. Among the accident victims, Indians had the lowest median liver vitamin A reserve (118 mg/kg) compared with that in other ethnic groups (137 mg/kg in Chinese, 191 mg/kg in Malays, 155 mg/kg in Caucasians).4. The ethnic distribution of vitamin A reserve in coronary deaths was similar to that in accident victims.5. There was no significant difference between the sexes in hepatic vitamin A reserve.6. The distribution of vitamin A reserve in all the groups was skewed to the right.

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