Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology
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Cardiovasc. Pathol. · Jul 2019
Comparative StudyThe role of hemodynamics in bicuspid aortopathy: a histopathologic study.
A bicuspid aortic valve (BAV) is the most common congenital cardiac malformation and is associated with ascending aortic dilation in 60%-80% of patients. In this study, we aimed to address the role of hemodynamic influences on the development of aortopathy in BAV patients. ⋯ In our study population, we could not demonstrate a potential distinct role for hemodynamics in the development of aortopathy in BAV patients even if corrected for aortic diameter, raphe position, or whether the valve is stenotic or regurgitant. The intimal layer and inner media however showed alterations in all jet specimens.
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Cardiovasc. Pathol. · May 2019
Iatrogenic embolization following cardiac intervention: postmortem analysis of 110 cases.
Iatrogenic embolization following cardiac investigative procedures may result from hydrophilic polymer emboli (HPE) from catheter valve and vessel wall calcifications, and air embolism from open heart surgery. This retrospective clinical pathologic analysis was undertaken to ascertain the frequency and extent of these potentially fatal complications. ⋯ We advocate for greater awareness of these underrecognized and occasionally fatal complications of endovascular procedures. Targeted postprocedural imaging has a role in the identification of iatrogenic embolic infarcts.
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Cardiovasc. Pathol. · Mar 2018
Comparative StudySurgical pathology of subaortic septal myectomy: histology skips over clinical diagnosis.
Subaortic septal myectomy is usually performed to mitigate obstruction in patients with the obstructive form of hypertrophic cardiomyopathy (HCM) or in those with congenital subaortic stenosis. Moreover, it is combined with aortic valve replacement in patients with severe aortic valve stenosis (SAS) and asymmetrical septal hypertrophy causing concomitant left ventricular outflow tract obstruction. When both conditions coexist, it is conceptually difficult to identify a cardiomyopathy beyond an adaptive myocardial hypertrophy, strictly related to pressure overload. Myectomy histopathology might be useful to enlighten the cause of the obstruction and establish the diagnosis. ⋯ In patients submitted to surgical septal myectomy, histology was mostly indistinctive among different clinical entities. Since different myocardial hypertrophy etiologies may share similar pathological expression, there is a need for detailed clinical assessment when trying to define the best strategy for clinical management.
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Cardiovasc. Pathol. · Mar 2018
Comparative StudySurvival kinase-dependent pathways contribute to gender difference in the response to myocardial ischemia-reperfusion and ischemic post-conditioning.
The response to ischemia/reperfusion and the effects of ischemic post-conditioning (IPC) are sex-dependent, but the mechanisms have not been clarified. Male (M) and female (F) rat hearts isolated and perfused using the Langendorff technique were subject to 30 min of global ischemia (GI) and 60 min reperfusion (R). In IPC hearts, three cycles of 30-sec GI/30-sec R were applied at the beginning of R. ⋯ Superoxide production, phospho-kinase activity, phospho-eNOS, and apoptosis increased in both sexes while antioxidants decreased in both sexes. After IPC, infarct size, superoxide production, and apoptosis decreased and phospho-eNOS increased in F and M hearts but phospho-kinase expressions and post-ischemic recovery of myocardial function improved only in M hearts. These results show that Akt/GSK-3β/PKCε/eNOS-dependent pathways-mediated superoxide production and apoptosis appear as important factors involved in the observed gender differences.
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Cardiovasc. Pathol. · Jan 2017
Loss of mechanical directional dependency of the ascending aorta with severe medial degeneration.
Biomechanical characterization of the aortic wall may help risk stratify patients with aneurysms. We investigated the degree of anisotropy, the directional dependency of mechanical properties, in control and aneurysmal ascending aortic tissue. We hypothesized that medial degeneration and aortic wall remodeling as found in aneurysmal tissue alter energy loss in both the circumferential and longitudinal directions, thereby reducing anisotropy. ⋯ Furthermore, the greatest energy loss anisotropy was found on the inner curvature of the aorta (P=.01). Energy loss demonstrates the directional dependency of aortic tissue. Energy loss isotropy is associated with medial degeneration, indicating that microstructural changes can be captured by global biomechanics, thereby identifying it as a marker of disease severity.