Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Bonschak, S.
Morphologische und morphometrische Analysen von Herzgewebsproben bei kardiovaskulären und Tumorerkrankungen - eine retrospektive Autopsiestudie
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 82
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Aigelsreiter Ariane
- Höfler Gerald
- Altmetrics:
- Abstract:
- Background: No. 1 cause of death is represented by cardiovascular diseases (CVDs), straightly followed by malignant growth. The metabolic syndrome (MetS) is a crucial component of CVDs as well as coronary artery disease; epicardial adipose tissue (EAT) is a scientifically proven risk factor for CVDs and MetS. Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) represents a subgroup of CVDs; it became known as sudden cardiac death, predominantly occurring in young athletic men. Cancer diseases can lead to a severe state of malnutrition, called ¿cancer anorexia cachexia syndrome¿ (CACS). This study was undertaken to determine alterations in macroscopic and microscopic parameters of the human heart in cardiovascular disease, metabolic syndrome and cancer diseases and to evaluate differences between these study groups. Special emphasis was put on EAT, ARVD/C and cancer cachexia. Materials and methods: Over a period of 18 months 41 deceased patients (mean age 67.76 ± 14.84 years; 16 female; 25 male) were conducted to the study while clinical-pathological autopsies. Tissue samples were taken from human hearts as well as anonymised documentations of medical history, body composition features and heart-specific anatomical parameters of each patient were consecutively created. Obtained tissue samples were preserved, processed (hematoxylin-eosin stain) and reviewed by light microscope assessment, supplemented by computer-assisted morphometric analysis. The study population was divided into 4 study groups: tumor, cardiovascular, metabolic and control group. Based on all collected data brought together, statistical analysis was performed and the results were compared between the study groups. Results: Macroscopic assessment revealed a significant difference in heart weight comparison among study groups (p = .05); metabolic and cardiovascular group showed increased heart weights in contrast to tumor and control group. With regard to coronary atherosclerosis (LAD) lipoid (45% of all patients), calcified (22.5%) and severe ruptured (30%) plaques were present in all study groups, whereby the latter was predominantly found in cardiovascular and metabolic patients. Microscopically fibro-fatty replacement of myocardial tissue (ARVD/C) was found in 60% of all histological slices; right ventricle was the most (34%) affected, whereas the atria were equally (each 25%) and left ventricle was the least (16%) affected. Morphometric analyses indicated significant differences between the study groups regarding the myocardial thickness of the right ventricle (p = .03); cardiovascular group had increased values in contrast to metabolic and tumor group. With regard to the epicardium ¿ myocardium ratio in the right ventricle (p = .04) tumor group offered a significant higher ratio in opposition to cardiovascular and control group. Conclusion: As ARVD/C-characteristically histological alterations of the myocardium were found within all study groups - predominantly in the right ventricle - we propose that this disease could be more common than previously assumed. Cancer patients offered the highest epicardium-myocardium ratio within this study; this result calls for further investigations, as the impact of cancer diseases on the human heart is not explored well yet. The data obtained here should act as baseline data for further studies.