Biomedical subjects

A Matsumori

Publications and source records attributed to A Matsumori.

At least 19 recordsLinked to original sources

PubMed1995

Dilated cardiomyopathy associated with hepatitis C virus infection.

BACKGROUND: Myocarditis is thought to be commonly caused by various viruses, and accumulating evidence links viral myocarditis with the eventual development of dilated cardiomyopathy. In many cases, however, the evidence is only circumstantial, and direct conclusive proof is not available. Polymerase chain reaction (PCR) has been used to detect enterovirus RNA in myocardial tissue, but the wide discrepancy in results emphasizes the need for further study. METHODS AND RESULTS: We investigated hepatitis C virus infection in patients with dilated cardiomyopathy. The presence, type, and quantity of hepatitis C virus RNA were evaluated in the sera, and the presence of positive and negative strands of hepatitis C virus RNA in the heart was investigated with the PCR technique. Anti-hepatitis C virus antibody was present in the sera of 6 of 36 patients (16.7%) with dilated cardiomyopathy and in 1 of 40 patients (2.5%) with ischemic heart disease, showing a statistically significant (P < .05) difference. At an earlier time, acute myocarditis was suspected in 3 patients who had developed acute onset of heart failure, and the diagnosis was confirmed by endomyocardial biopsy in 1 patient. Hepatitis C virus RNA was present in the sera of 4 of the 6 patients, and all 4 had hepatitis C virus type II. The copy number of hepatitis C virus RNA in the serum was 8 x 10(2) to 2 x 10(3) genomes per 1 mL serum. Positive strands of hepatitis C virus were found in the hearts of 3 patients, and negative strands of hepatitis C virus were detected in the heart of 1 patient. CONCLUSIONS: The results suggest that hepatitis C virus infection is frequently found in patients with dilated cardiomyopathy and that hepatitis C virus is an important causal agent in the pathogenesis of the disease. Antiviral therapy against hepatitis C virus may be indicated in these patients.

Adult↗

PubMed1995

Mutations in the genes for cardiac troponin T and alpha-tropomyosin in hypertrophic cardiomyopathy.

BACKGROUND: Familial hypertrophic cardiomyopathy can be caused by mutations in the genes for beta cardiac myosin heavy chain, alpha-tropomyosin, or cardiac troponin T. It is not known how often the disease is caused by mutations in the tropomyosin and troponin genes, and the associated clinical phenotypes have not been carefully studied. METHODS: Linkage between polymorphisms of the alpha-tropomyosin gene or the cardiac troponin T gene and hypertrophic cardiomyopathy was assessed in 27 families. In addition, 100 probands were screened for mutations in the alpha-tropomyosin gene, and 26 were screened for mutations in the cardiac troponin T gene. Life expectancy, the incidence of sudden death, and the extent of left ventricular hypertrophy were compared in patients with different mutations. RESULTS: Genetic analyses identified only one alpha-tropomyosin mutation, identical to one previously described. Five novel mutations in cardiac troponin were identified, as well as a further example of a previously described mutation. The clinical phenotype of four troponin T mutations in seven unrelated families was similar and was characterized by a poor prognosis (life expectancy, approximately 35 years) and a high incidence of sudden death. The mean (+/- SD) maximal thickness of the left ventricular wall in subjects with cardiac troponin T mutations (16.7 +/- 5.5 mm) was significantly less than that in subjects with beta cardiac myosin heavy-chain mutations (23.7 +/- 7.7 mm, P < 0.001). CONCLUSIONS: Mutations in alpha-tropomyosin are a rare cause of familial hypertrophic cardiomyopathy, accounting for approximately 3 percent of cases. Mutations in cardiac troponin T account for approximately 15 percent of cases of familial hypertrophic cardiomyopathy in this referral-center population. These mutations are characterized by relatively mild and sometimes subclinical hypertrophy but a high incidence of sudden death. Genetic testing may therefore be especially important in this group.

Adolescent↗

PubMed1995

Experimental graft coronary artery disease in a murine heterotopic cardiac transplant model.

BACKGROUND: The development of immunosuppressive therapy has brought about a remarkable decrease in the risk of acute cardiac allograft rejection; however, the major cause of patient death or retransplantation after the first postoperative year is coronary artery disease (CAD) in the graft. The pathogenesis and management of CAD are still not clearly established. METHODS AND RESULTS: To make an animal model of CAD, we performed primary vascularized heterotopic cardiac transplantation using mice. Inbred strains, sharing major histocompatibility antigens but differing in minor antigens, were selected. DBA/2 mice (H-2d) served as donors and B10.D2 mice (H-2d) as recipients. Viability of the cardiac grafts was assessed by abdominal palpation. Eight of twelve cardiac allografts (67%) survived for 10 weeks after operation without any immunosuppressive therapy. Allografts rejected within 4 weeks showed acute rejection histologically, whereas allografts surviving more than 4 weeks displayed intimal hyperplasia in the coronary arteries, together with interstitial and perivascular fibrosis. The severity of intimal thickening in the graft coronary artery was then assessed by point counting. In allografts surviving for 70 days, intima comprised approximately 42% of the graft arterial wall, whereas in DBA/2 and B10.D2 syngeneic grafts, it comprised approximately 13%. A significant difference in percentage was observed between the intima area of allografts and that of syngrafts (P < .01, ANOVA). Long-term oral administration of cyclosporine at a dose of 40 mg/kg per day decreased the intima area to 34% (P < .05 versus nontreated allografts, ANOVA); however, this dose did not affect the incidence of arterial lesions. CONCLUSIONS: The histopathological features of DBA/2 allografts surviving for 10 weeks in B10.D2 recipient mice mimicked those in human CAD. Using this animal model, the beneficial effect of low-dose cyclosporine therapy on CAD was demonstrated, although this effect seemed to be limited. This DBA/2-B10.D2 mouse heterotypic cardiac transplant model provides valuable results for future studies of the disease.

Animals↗

PubMed1995

Beneficial effect of amrinone on murine cardiac allograft survival.

Amrinone is a non-glycoside positive inotropic agent with an inhibitory effect on a cyclic adenosine monophosphate (AMP) phosphodiesterase isoenzyme. In the present study, we examined the immunosuppressive action of amrinone, since several other cyclic AMP-elevating agents have been shown to suppress T lymphocyte activation. First, the in vivo effects of amrinone were investigated. Oral amrinone treatment, at 40 mg/kg per day, significantly prolonged median cardiac allograft survival compared with non-treated controls (22.0 days versus 10.5 days, P < 0.01) when DBA/2 mouse hearts (H-2d) were heterotopically transplanted into C57B1/6 mice (H-2b). Histopathological examination showed that there was less prominent cellular infiltration in the amrinone-treated than in the non-treated allografts. Plasma amrinone concentrations of mice after a single oral dose of 40 mg/kg were within the range of clinical relevance. To clarify the mechanism of action, in vitro studies were done. The generation of specific cytotoxic T lymphocytes after mixed lymphocyte culture was significantly suppressed by addition of amrinone to the culture medium at 5 micrograms/ml. The production of IL-2 and the interferon-gamma during mixed lymphocyte culture was also suppressed by amrinone at 5 micrograms/ml. However, the level of intracellular cyclic AMP in mouse splenic lymphocytes was not affected significantly by the same dose of amrinone. In conclusion, amrinone has immunosuppressive actions at the therapeutic doses, and it may be a beneficial agent for therapy against acute cardiac allograft rejection.

Amrinone↗

PubMed1995

[Myocardial uptake ratio of iodine-123 labeled beta-methyl iodophenylpentadecanoic acid (123I-BMIPP) in relation to the concentration of the substrates of energy].

Iodine-123 beta-methyl iodophenylpentadecanoic acid (BMIPP) has been used for evaluating myocardial fatty acid metabolism in vivo. The whole body BMIPP imaging was acquired in 26 patients (11 with HCM, 11 with CAD and 4 with DCM) to calculate % uptake in the myocardium and to correlate its uptake with biochemical data, including blood sugar (BS), nonesterified fatty acid (NEFA) and insulin in the blood. BMIPP was administered at rest with overnight fasting state, and the anterior and posterior whole body imaging was performed one hour later. The background corrected whole myocardial counts were calculated to obtain %BMIPP uptake. In addition, the heart to mediastinum count ratio (H/M ratio) was calculated from the mean counts in the heart and the upper mediastinum in the anterior view. The %BMIPP uptake was 3.70 +/- 1.22% and H/M ratio was 2.30 +/- 0.23. The patients with DCM showed higher %BMIPP uptake values (DCM = 5.58 +/- 0.67% vs. CAD = 3.09 +/- 0.97% and HCM = 3.63 +/- 0.86%, both p < 0.01), but similar values of H/M ratio with other patients (DCM = 2.43 +/- 0.20, CAD = 2.22 +/- 0.25 and HCM = 2.32 +/- 0.20). Although the biochemical data varied at the time of the tracer administration, they were not significantly correlated with the %BMIPP uptake or H/M ratio. However, there was a significant correlation between %BMIPP uptake and H/M ratio with the correlation coefficient of 0.80 (p < 0.001). We conclude that the myocardial uptake of BMIPP is not influenced by the plasma substrate level under the fasting state.

Blood Glucose↗

PubMed1995

[Detection of viral genomes in myocarditis].

Although much evidence favors the concept that dilated cardiomyopathy could be a postviral disease, the actual prevalence and pathogenesis of viral heart disease in dilated cardiomyopathy has not been well explored, since the diagnosis of viral infection is still difficult. The recently developed polymerase chain reaction (PCR) has made it possible to amplify a few copies of viral genome and has shown that viral genomes persist long after viral infection. The PCR is a promising method for testing possible viral etiology. We have found that antiheart antibodies associated with a murine model of myocarditis increased the intracellular free Ca2+ concentration through the activation of Ca(2+)-permeable cation channels in isolated ventricular cells. Marked induction of Mn-SOD and Cu/Zn-SOD mRNA was found in the heart with viral myocarditis and oxygen radicals may play an important role in the pathogenesis of viral myocarditis. Our recent studies revealed an increase in the circulating cytokines in patients with acute myocarditis and cardiomyopathy and suggested that cytokines play some role in the pathogenesis of myocardial injury in these diseases. In our animal model of EMC virus myocarditis, plasma tumor necrosis factor (TNF)-alpha was elevated in the acute stage and exogenously administered anti TNF-alpha antibody improved the survival and myocardial lesion, suggesting the importance of TNF-alpha in the pathogenesis.

Animals↗

PubMed1994

Vesnarinone prolongs survival and reduces lethality in a murine model of lethal endotoxemia.

Vesnarinone (3,4-Dihydro-6-[4(3,4-dimethoxybenzoyl)-1-piperanizyl]-2(1H)-quino linone), a recently synthesized quinolinone derivative with positive inotropic properties, has been reported the survival of patients with chronic congestive heart failure. However, the mechanisms that contribute to this improvement are not yet well understood. There is increasing evidence that vesnarinone has novel immunosuppressive properties related to its inhibition of cytokine production. Cytokines have been shown to play a pivotal role in the pathophysiologic consequences of fatal bacteremic shock. In this study, we investigated the effects of vesnarinone in a murine model of lethal endotoxemia induced by lipopolysaccharide (LPS). Eight-week-old female BALB/c mice were given 300 or 400 micrograms of LPS, and 50 or 100 mg/kg of vesnarinone was administered by oral gavage and/or 10 or 30 micrograms of vesnarinone was given intra peritoneally. Vesnarinone prolonged the median survival time and reduced lethality when given at the same time as the LPS injection. However, vesnarinone did not have a beneficial effect when administered 2 hours after LPS treatment. Plasma TNF-alpha reached a maximum level 1 hour after LPS challenge, and vesnarinone reduced the plasma level of TNF-alpha, when administered at the same time as LPS injection. Vesnarinone had protective effects against lethal endotoxemia; these effects were considered to be due to the suppression of TNF-alpha production. These findings suggest that vesnarinone may be a promising agent for the treatment of bacterial sepsis and shock.

Animals↗

PubMed1994

Inhibition of cytokine production by a new inotropic agent, vesnarinone, in human lymphocytes, T cell line, and monocytic cell line.

Vesnarinone, a recently synthesized quinolinone derivative with positive inotropic properties, has been reported to improve survival of patients with congestive heart failure. However, the mechanisms that contribute to the increased survival are unknown. In this study, we showed vesnarinone had inhibitory effects on the production of tumor necrosis factor-alpha, interferon-gamma, interleukin-1 beta and interleukin-2 by stimulated human peripheral blood mononuclear cells, human Jurkat T cell line and THP-1 monocytic cell line. Vesnarinone may exert its beneficial effect on patients with congestive heart failure, in part, by its immunomodulating activity.

Adult↗

PubMed1994

Increased circulating cytokines in patients with myocarditis and cardiomyopathy.

OBJECTIVES: To elucidate the potential role of cytokines in the pathogenesis of cardiomyopathy and myocarditis. BACKGROUND: Experimental studies show that certain cytokines depress myocardial contractility and that tumour necrosis factor-alpha plays an important part in the pathogenesis of myocardial injury in animal models of viral and autoimmune myocarditis. METHODS: Plasma interleukin 1-alpha, interleukin 1-beta, interleukin-2, interleukin-6, tumour necrosis factor-alpha, tumour necrosis factor-beta, granulocyte-macrophage colony stimulating factor, granulocyte colony stimulating factor, macrophage colony stimulating factor, interferon-alpha and interferon-gamma were measured in 13 patients with acute myocarditis, 23 patients with dilated cardiomyopathy, 51 patients with hypertrophic cardiomyopathy, nine patients with acute myocardial infarction, 18 patients with angina pectoris, 12 patients with essential hypertension and 17 healthy controls. RESULTS: Increased concentrations of cytokines were not detected in the controls. In patients with acute myocarditis, interleukin 1-alpha was detected in 23% (mean (SD) 25 (11) pg/ml), tumour necrosis factor-alpha in 46% (61 (31) pg/ml), and macrophage colony stimulating factor was 2.5 (1.8) ng/ml (normal 1.9 (0.4)). In patients with dilated cardiomyopathy, tumour necrosis factor-alpha was detected in 35% (402 (555) pg/ml). In patients with hypertrophic cardiomyopathy, interleukin-2 was detectable in 14% (2318 (4738) pg/ml) and tumour necrosis factor-alpha ws detected in 20% (992 (1517) pg/ml). The concentration of macrophage colony stimulating factor was raised in patients with acute myocardial infarction. Granulocyte colony stimulating factor was often increased in myocarditis, cardiomyopathies, acute myocardial infarction, and angina pectoris--suggesting activation of macrophages and/or endothelial cells--but this increase was not specific to these diseases. Increased concentrations of cytokines were not found in patients with essential hypertension. CONCLUSION: These results suggest that cytokines may play a part in the pathogenesis of myocardial injury in myocarditis and cardiomyopathies and that further studies to explore the potential pathogenetic role of cytokines in myocardial diseases may be warranted.

Adult↗

PubMed1994

Therapeutic effect of anti-tumor necrosis factor-alpha antibody on the murine model of viral myocarditis induced by encephalomyocarditis virus.

BACKGROUND: Tumor necrosis factor-alpha (TNF-alpha) has been reported to have an antiviral effect in vitro; however, its in vivo effect remains to be clarified. METHODS AND RESULTS: To investigate the role of TNF-alpha in viral myocarditis using a murine model induced by encephalomyocarditis virus (EMCV), we evaluated (1) plasma TNF-alpha levels by enzyme-linked immunosorbent assay (ELISA), (2) the effect of recombinant human TNF-alpha for its possible antiviral effect in vivo, and (3) the effect of anti-murine TNF-alpha monoclonal antibody (mAb) in vivo. Four-week-old DBA/2 mice were inoculated intraperitoneally with EMCV (day 0). Mice were injected intravenously daily with 1 microgram of TNF-alpha or 2 x 10(3) units of anti-TNF-alpha mAb starting on day -1, day 0, or day 1 until day 2 (TNF-alpha study) or day 4 (anti-TNF-alpha mAb study). A portion of the mice were killed on day 5 (protocol 1); their hearts were removed, and plaque assays were performed to demonstrate the myocardial virus content. The remaining mice were killed on day 14 (protocol 2); myocardial lesions were examined histopathologically in terms of severity, and their survival rates were determined. Plasma TNF-alpha concentration was elevated in the blood of infected mice compared with uninfected mice 3, 5, and 7 days after virus inoculation. The myocardial virus content was higher in the TNF-alpha-treated group than in the control group. Histopathological analysis revealed that myocardial necrosis and cellular infiltration were more prominent in the TNF-alpha group than in the control group. The anti-TNF-alpha mAb improved survival and myocardial lesions when its treatment was started 1 day before virus inoculation. However, it showed no therapeutic effect when administered simultaneously with the inoculation or on day 1. CONCLUSIONS: TNF-alpha may play an important role in the very early stage of the immune response, and anti-TNF-alpha mAb may prevent the early pathway of acute viral myocarditis.

Animals↗

PubMed1994

Vesnarinone, a new inotropic agent, inhibits cytokine production by stimulated human blood from patients with heart failure.

BACKGROUND: Vesnarinone, a quinolinone derivative, is a recently synthesized positive inotropic agent that has been shown to dramatically improve the survival of patients with heart failure. However, the mechanism of action of vesnarinone remains unknown. Reversible neutropenia complicated with vesnarinone therapy suggests that vesnarinone may modulate the production of cytokines. Because tumor necrosis factor (TNF)-alpha and other cytokines have been shown to depress myocardial contractility, we investigated the effects of vesnarinone on the production of various cytokines. METHODS AND RESULTS: We studied the effects of vesnarinone on cytokine production by lipopolysaccharide (LPS)-stimulated whole blood from seven patients with heart failure and from five healthy volunteers. Heparinized blood was diluted in RPMI and stimulated with LPS. Vesnarinone was added in a range of 1 to 30 micrograms/mL, the blood was incubated for 24 hours, and interleukin (IL)-1 alpha, IL-1 beta, IL-6, TNF-alpha, interferon (IFN)-gamma, and granulocyte colony-stimulating factor (G-CSF) were measured by an enzyme-linked immunosorbent assay. LPS stimulation induced a more prominent increase in TNF-alpha in patients with heart failure than in healthy volunteers. Vesnarinone inhibited the production of TNF-alpha and IFN-gamma both in healthy volunteers and in patients with heart failure. IL-1 alpha and IL-1 beta were also suppressed in healthy volunteers, but this response was variable, and a significant reduction was not seen in patients with heart failure. Marked inhibition of G-CSF and other cytokines by vesnarinone was observed in one patient who had developed neutropenia as a result of vesnarinone therapy. CONCLUSIONS: Although the number of study patients was small and the results are preliminary, these findings provide evidence that vesnarinone plays an important role in the regulation of cytokines and suggest that the reduction of cytokine release may contribute to the beneficial effects of the drug in the treatment of heart failure. Furthermore, the measurement of cytokines may be useful in predicting the occurrence of neutropenia, which has been occasionally reported in patients treated with vesnarinone.

Blood↗

PubMed1994

An angiotensin II receptor antagonist reduces myocardial damage in an animal model of myocarditis.

BACKGROUND: Recently, an angiotensin-converting enzyme inhibitor was shown to have a beneficial effect on virus-induced myocardial injury. We investigated the effect of a new angiotensin II type 1 receptor antagonist, (+-)-1-(cyclohexyloxycarbonyloxy)ethyl 2-ethoxy-1-([2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl)-1H-benz imi dazole-7- carboxylate (TCV-116), in an animal model of viral myocarditis induced by encephalomyocarditis virus. METHODS AND RESULTS: Four-week-old DBA/2 mice were inoculated with the encephalomyocarditis virus. TCV-116 (in 5% gum arabic) was given 1 day before (1 or 10 mg/kg) or 2 days after virus inoculation (0.3 or 3 mg/kg). Control mice received the vehicle only. All drugs were administered orally on a daily basis, and the animals were killed on day 14. When treatment was started 1 day before inoculation, the survival of mice receiving 10 mg/kg of TCV-116 improved (17 of 20 [85%] versus 14 of 22 [64%] control mice), but the difference was not significant. Heart weight (106 +/- 24 mg versus 133 +/- 33 mg, P < .05), histological scores for myocardial necrosis (1.1 +/- 0.3 versus 2.3 +/- 1.2, P < .01), cellular infiltration (1.4 +/- 0.7 versus 2.6 +/- 1.3, P < .05), and calcification (1.1 +/- 0.3 versus 2.1 +/- 1.1, P < .01) were significantly decreased in mice given TCV-116 at 3 mg/kg compared with the vehicle control mice. The plasma angiotensin II level was significantly higher in infected mice than in noninfected mice (71.8 +/- 30.2 versus 31.8 +/- 22.5 pg/mL, P < .05). TCV-116 did not inhibit viral replication in the heart. CONCLUSIONS: This study suggests that angiotensin II plays an important pathophysiological role in viral myocarditis. Treatment with TCV-116, an angiotensin II receptor antagonist, had a cardioprotective effect.

Angiotensin II↗

PubMed1994

Treatment of virus-induced myocardial injury with a novel immunomodulating agent, vesnarinone. Suppression of natural killer cell activity and tumor necrosis factor-alpha production.

Controversy still exists concerning the therapy for viral myocarditis which manifests a wide variety of clinical symptoms. Vesnarinone, a quinolinone derivative that was developed as a positive inotropic agent with complex actions, including phosphodiesterase inhibition and cation channel modification, has recently been confirmed to improve the prognosis of patients with chronic heart failure. However, the precise mechanism of this beneficial effect is not yet clearly understood. In this study, using a murine model of acute viral myocarditis resulting from encephalomyocarditis virus infection, survival and myocardial damage were markedly improved by treatment with vesnarinone. In contrast, survival was not improved by treatment with amrinone, a phosphodiesterase inhibitor. Although vesnarinone did not inhibit viral replication or protect myocytes from viral direct cell injury, it did inhibit the increase in natural killer cell activity after viral infection. On the other hand, amrinone failed to inhibit natural killer cell activity. Both vesnarinone and amrinone suppressed the production of tumor necrosis factor-alpha. Therefore, we postulate that vesnarinone exerted its beneficial effects through an inhibition of natural killer cell activity, and that it serves as an immunomodulator providing new therapeutic possibilities for the treatment of viral myocarditis and/or immunological disorders.

Amrinone↗

PubMed1994

Autoantibodies against vimentin in a murine model of myocarditis.

The presence of autoantibodies in the sera of patients with myocarditis has suggested that autoimmunity is a sequela of myocarditis. In this study, we examined anti-vimentin antibodies in a murine model of myocarditis. Four-week-old male DBA/2 mice were inoculated intraperitoneally with 10 plaque-forming units of encephalomyocarditis (EMC) virus. The surviving mice were killed on Days 0 (n = 7), 2 (n = 6), 5 (n = 6), 7 (n = 6), 9 (n = 6), 14 (n = 5), 60 (n = 6) and 540 (n = 3) after virus inoculation. The presence of anti-vimentin autoantibodies in the sera of mice was determined by ELISA. The optical density (OD) of anti-vimentin IgG and IgM autoantibodies of day 0 mice was 0.03 +/- 0.03 and 0.12 +/- 0.08, respectively, when positive antibody was defined as over the mean value plus 2-standard deviations of the sera of day 0 mice, anti-vimentin IgG antibodies were negative before day 5 but positive in all mice on day 9. Both IgG and IgM OD of the sera from day 9 mice (IgG; 0.26 +/- 0.12, IgM; 0.30 +/- 0.08) were significantly higher than those of the sera from day 0 mice (p < 0.005) and decreased thereafter on day 14. In the chronic stage, five of six mice were positive on day 60 and two of three mice were positive on day 540. Although further studies are needed to elucidate the pathogenetic role of anti-vimentin antibodies, these antibodies may be a parameter of the interstitial injury.

Animals↗

PubMed1994

[Comparative study of 201Tl-scintigraphic image and endomyocardial biopsy findings in patients with dilated cardiomyopathy].

201Tl-SPECT image was compared with the findings of endomyocardial biopsy in patients with dilated cardiomyopathies (DCM), and diagnostic value of 201Tl patchy pattern image for fibrosis with DCM was evaluated. Serial 22 patients diagnosed as DCM with endomyocardial biopsy findings were selected for this study (age: 50 +/- 17 y.o., Male/Female = 17/5). Patchy pattern of 201Tl-SPECT image was visually classified to 4 stage according to the severity of inhomogeneous defect, and pathologic findings of fibrosis was also classified into 4 according to the severity of fibrosis (0: none, 1: mild, 2: moderate, 3: severe). Ejection fraction calculated from left ventriculography and end-diastolic dimension by echocardiography were also compared with 201Tl-SPECT image. Out of 22 patients, 21 patients (95%) showed fibrosis, and 18 patients (82%) showed patchy pattern with 201Tl-SPECT. Severity of patchy pattern was not in good relation to that of fibrosis (r = 0.374). 201Tl image was not related to the function nor dimension. Four autopsy studies revealed a good relation of macroscopic severity, spatial distribution of fibrosis and inhomogeneous 201Tl-defect pattern before death. Patchy pattern of 201Tl-SPECT image will show the myocardial fibrosis in patients with DCM, and is independent of the function. 201Tl-SPECT may show more clinically useful findings of spatial distribution and severity of fibrosis with focal myocardial biopsy.

Adolescent↗

PubMed1993

Activation of Ca-permeable cation channels by myocarditis-associated antibody in guinea pig ventricular myocytes.

The pathogenesis of myocarditis and dilated cardiomyopathy is though to involve autoimmunological processes and myocardial calcium overload. Serum containing antiheart antibodies associated with a murine model of myocarditis increased [Ca2+]i in guinea pig ventricular myocytes only in the presence of extracellular Ca2+. The antiheart antibody-positive serum activated Ca(2+)-permeable cation channels that were insensitive to dihydropyridines and membrane stretch. The permeability sequence was Ba2+ > Ca2+ > Na+ approximately K+, and the single-channel conductance to Ba2+ was 12 pS. The channel was activated by extracellular application of the serum during on-cell recording, which suggests that a soluble intracellular messenger may be involved. The antibody-positive serum did not alter voltage-gated Ca2+ currents. We propose that excess Ca entry in myocarditis and dilated cardiomyopathy results from activation of a Ca(2+)-permeable cationic channel by the autoantibodies.

Animals↗

PubMed1993

Independent origin of identical beta cardiac myosin heavy-chain mutations in hypertrophic cardiomyopathy.

The origins of the beta cardiac myosin heavy-chain (MHC) gene missense mutations that cause familial hypertrophic cardiomyopathy (FHC) in 14 families have been evaluated. Of eight different mutations, four were present in single families, while four occurred in two or more families. To investigate the origins of the four shared mutations, we defined the beta cardiac MHC haplotypes of each of the mutation-bearing chromosomes by determining the alleles present at three intragenic polymorphic loci. Two of the mutations (Arg453Cys and Val606Met) have arisen independently in each of three families, being found on different chromosomal backgrounds. A third mutation (Gly584Arg) is associated with identical haplotypes in two families with Portuguese ancestors, suggesting a founder effect. Haplotype analysis was uninformative for the fourth mutation (Arg403Gln). Thus, FHC-causing mutations have arisen independently in at least 12 of the 14 families studied, suggesting that the majority have arisen relatively recently as new mutations. This finding predicts the prevalence of disease-causing beta cardiac MHC mutations to be comparable in all population groups.

Base Sequence↗

PubMed1993

[Metabolism of failing myocardium].

Cardiac function is maintained by a change in chemical high energy to mechanical work. In the stressed heart, there may be a primary disturbance in the energy producing systems and energy utilizing systems. A series of metabolic adaptations occur--increased contractile units and economy of contraction etc.. But failure of adaptation causes the development of heart failure. In the failing myocardium, there are various metabolic changes-loss of myocytes, decreased rate of oxidative phosphorylation, decreased activity of mitochondrial and cytosolic enzymes, which correlate energy production, impairment of calcium transport, decreased sensitivity to catecholamine, decreased response of contractile units, inappropriate production of some humoral factors, such as the renin-angiotensin system or cytokines. In addition, these factors may induce a "vicious cycle". However, a number of problems to be solved still exist.

Autoimmunity↗