Franziska Degener1, Aida Salameh2, Tatiana Manuylova3, Thomas Pickardt4, Martin Kostelka5, Ingo Daehnert2, Felix Berger6, Daniel Messroghli7, Stephan Schubert8, Karin Klingel3. 1. German Heart Center Berlin, Department of Congenital Heart Disease, Pediatric Cardiology, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Charité, Universitätsmedizin Berlin, Institute for Institute for Cardiovascular Computer-assisted Medicine, Berlin, Germany. Electronic address: degener@dhzb.de. 2. Heart Center, University of Leipzig, Clinic for Pediatric Cardiology, Leipzig, Germany. 3. Cardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany. 4. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Competence Network for Congenital Heart Defects, Berlin, Germany. 5. Heart Center, University of Leipzig, Department of Cardiac Surgery, Leipzig, Germany. 6. German Heart Center Berlin, Department of Congenital Heart Disease, Pediatric Cardiology, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Charité, Universitätsmedizin Berlin, Department for Paediatric Cardiology, Berlin, Germany. 7. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; German Heart Center, Internal Medicine, Cardiology, Berlin, Germany; Charité, Universitätsmedizin Berlin, Department for Cardiology, Berlin, Germany. 8. German Heart Center Berlin, Department of Congenital Heart Disease, Pediatric Cardiology, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany.
Abstract
BACKGROUND: Endomyocardial biopsies (EMB) are the gold standard for the diagnosis of myocarditis in children and adults. The existing WHO/ISFC criteria for lymphocytic cell infiltrates by are based on the myocardium of adults. The aim of this study was to present a paediatric control cohort for the evaluation of inflammation in EMB of children. METHODS: In this study endomyocardial tissue from 62 children under 4 years of age was investigated, being collected during a planned open heart surgery with routine resection from ventricular site. Patients had no history of infection or myocardial inflammation. The heart tissue was formalin fixed and embedded in paraffin. Four μm thick tissue sections were stained with haematoxylin and eosin, Masson's trichrome, and Giemsa. Immunohistochemical stainings included quantitative evaluation of CD3+ T cells, CD20+ B cells, CD68+ macrophages and MHCII expression. RESULTS: The myocardium was obtained in 96.8% (n = 60) of the cases from the right and in 3.2% (n = 2) from the left ventricle. The median age (interquartile range) at biopsy was 0.5 years (0.3-0.9), 66.1% male. Within this cohort, a median of 2.5/mm2 (1.0-4.0) CD3+ T cells, 0.5/mm2 (0.0-0.6) CD20+ B cells and 4.0/mm2 (2.5-6.0) CD68+ macrophages were detected. The MHC II grade was 0 in 71.0% (n = 44) and 1 in 29.0% (n = 18). CONCLUSION: This is the first paediatric control cohort being relevant for the correct interpretation of inflammatory heart diseases in EMB. The lymphocytic cell numbers in children needing congenital heart surgery without myocardial inflammation are below the existing values in adults.
BACKGROUND: Endomyocardial biopsies (EMB) are the gold standard for the diagnosis of myocarditis in children and adults. The existing WHO/ISFC criteria for lymphocytic cell infiltrates by are based on the myocardium of adults. The aim of this study was to present a paediatric control cohort for the evaluation of inflammation in EMB of children. METHODS: In this study endomyocardial tissue from 62 children under 4 years of age was investigated, being collected during a planned open heart surgery with routine resection from ventricular site. Patients had no history of infection or myocardial inflammation. The heart tissue was formalin fixed and embedded in paraffin. Four μm thick tissue sections were stained with haematoxylin and eosin, Masson's trichrome, and Giemsa. Immunohistochemical stainings included quantitative evaluation of CD3+ T cells, CD20+ B cells, CD68+ macrophages and MHCII expression. RESULTS: The myocardium was obtained in 96.8% (n = 60) of the cases from the right and in 3.2% (n = 2) from the left ventricle. The median age (interquartile range) at biopsy was 0.5 years (0.3-0.9), 66.1% male. Within this cohort, a median of 2.5/mm2 (1.0-4.0) CD3+ T cells, 0.5/mm2 (0.0-0.6) CD20+ B cells and 4.0/mm2 (2.5-6.0) CD68+ macrophages were detected. The MHC II grade was 0 in 71.0% (n = 44) and 1 in 29.0% (n = 18). CONCLUSION: This is the first paediatric control cohort being relevant for the correct interpretation of inflammatory heart diseases in EMB. The lymphocytic cell numbers in children needing congenital heart surgery without myocardial inflammation are below the existing values in adults.
Authors: Franziska Seidel; Carmen Scheibenbogen; Harald Heidecke; Bernd Opgen-Rhein; Thomas Pickardt; Karin Klingel; Felix Berger; Daniel Messroghli; Stephan Schubert Journal: Front Pediatr Date: 2022-04-28 Impact factor: 3.418
Authors: Franziska Seidel; Kai Thorsten Laser; Karin Klingel; Josephine Dartsch; Simon Theisen; Thomas Pickardt; Manuel Holtgrewe; Anna Gärtner; Felix Berger; Dieter Beule; Hendrik Milting; Stephan Schubert; Sabine Klaassen; Jirko Kühnisch Journal: J Cardiovasc Dev Dis Date: 2022-07-05