BACKGROUND: Pulmonary embolism (PE) is a significant cause of morbidity and mortality. In a recent study in patients with PE, an increased level of macrophages was found in the right ventricle. OBJECTIVE: To evaluate the presence of inflammatory cells, myocytolysis and intracavitary thrombi in the left and right ventricle of patients who died because of PE as a putative new source of heart failure. PATIENTS AND METHODS: 22 patients with PE were studied. For comparison, eight controls and 11 patients who died of chronic pulmonary hypertension (PHT) were used. Slides of the left and right ventricle were stained with antibodies, identifying neutrophilic granulocytes, lymphocytes and macrophages, which were subsequently quantified. Myocytolysis was visualised using complement staining. Thrombi were identified by conventional staining. RESULTS: Compared with controls, in patients with PE a significant increase in extravascular localisation of all three inflammatory cells was found both in the right and left ventricle, coinciding with myocytolysis, indicative for myocarditis. No increase in inflammatory cells was found in patients with PHT. Endocardial cellular infiltration was also found, partly coinciding with the presence of ventricular thrombi. CONCLUSIONS: In patients with PE, endomyocarditis and intracavitary thrombi in the left and right ventricle were found. These abnormalities may be an additional new explanation for the observed cardiac enzyme release and functional abnormalities of the heart in these patients and may contribute to the morbidity and mortality of the disease.
BACKGROUND:Pulmonary embolism (PE) is a significant cause of morbidity and mortality. In a recent study in patients with PE, an increased level of macrophages was found in the right ventricle. OBJECTIVE: To evaluate the presence of inflammatory cells, myocytolysis and intracavitary thrombi in the left and right ventricle of patients who died because of PE as a putative new source of heart failure. PATIENTS AND METHODS: 22 patients with PE were studied. For comparison, eight controls and 11 patients who died of chronic pulmonary hypertension (PHT) were used. Slides of the left and right ventricle were stained with antibodies, identifying neutrophilic granulocytes, lymphocytes and macrophages, which were subsequently quantified. Myocytolysis was visualised using complement staining. Thrombi were identified by conventional staining. RESULTS: Compared with controls, in patients with PE a significant increase in extravascular localisation of all three inflammatory cells was found both in the right and left ventricle, coinciding with myocytolysis, indicative for myocarditis. No increase in inflammatory cells was found in patients with PHT. Endocardial cellular infiltration was also found, partly coinciding with the presence of ventricular thrombi. CONCLUSIONS: In patients with PE, endomyocarditis and intracavitary thrombi in the left and right ventricle were found. These abnormalities may be an additional new explanation for the observed cardiac enzyme release and functional abnormalities of the heart in these patients and may contribute to the morbidity and mortality of the disease.
Authors: Romain Chopard; Umberto Campia; Lucas Morin; Karola S Jering; Zaid I Almarzooq; Julia Elizabeth Snyder; Samantha Rizzo; Aaron B Waxman; Samuel Z Goldhaber; Gregory Piazza Journal: J Thromb Thrombolysis Date: 2022-09-03 Impact factor: 5.221
Authors: Sue Gu; Claudia Mickael; Rahul Kumar; Michael H Lee; Linda Sanders; Biruk Kassa; Julie Harral; Jason Williams; Kirk C Hansen; Kurt R Stenmark; Rubin M Tuder; Brian B Graham Journal: Pulm Circ Date: 2022-07-01 Impact factor: 2.886
Authors: Maria J Overbeek; Koen T B Mouchaers; Hans M Niessen; Awal M Hadi; Koba Kupreishvili; Anco Boonstra; Alexandre E Voskuyl; Jeroen A M Belien; Egbert F Smit; Ben C Dijkmans; Anton Vonk-Noordegraaf; Katrien Grünberg Journal: Int J Rheumatol Date: 2010-09-30
Authors: Akylbek Sydykov; Argen Mamazhakypov; Aleksandar Petrovic; Djuro Kosanovic; Akpay S Sarybaev; Norbert Weissmann; Hossein A Ghofrani; Ralph T Schermuly Journal: Front Physiol Date: 2018-05-23 Impact factor: 4.566
Authors: Martin C J Kneyber; Roel P Gazendam; Hans W M Niessen; Jan-Willem Kuiper; Claudia C Dos Santos; Arthur S Slutsky; Frans B Plötz Journal: Crit Care Date: 2009-06-09 Impact factor: 9.097