Cardiovascular Pathology
Volume 19, Issue 4 , Pages e99-e105 , July 2010

Utility of immunofluorescence and electron microscopy in endomyocardial biopsies from patients with unexplained heart failure

  • Rosemary C. She

      Affiliations

    • Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
    • Corresponding Author InformationCorresponding author. ARUP Laboratories, 500 Chipeta Way, Salt Lake City, UT 84108, USA. Tel.: +1 801 583 2787; fax: +1 801 584 5207.
    • ,
  • Elizabeth H. Hammond

      Affiliations

    • Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
    • Department of Pathology, LDS Hospital, Intermountain Healthcare, Salt Lake City, UT, USA

Received 11 August 2008 ,Revised 7 March 2009 ,Accepted 14 April 2009.

References 

  1. Aretz HT. Myocarditis: the Dallas criteria. Hum Pathol. 1987;18:619–624
  2. Fairweather D, Kaya Z, Shellam GR, Lawson CM, Rose NR. From infection to autoimmunity. J Autoimmun. 2001;16:175–186
  3. Neu N, Klieber R, Fruhwirth M, Berger P. Cardiac myosin-induced myocarditis as a model of postinfectious autoimmunity. Eur Heart J. 1991;12(Suppl D):117–120
  4. Opavsky MA, Penninger J, Aitken K, et al. Susceptibility to myocarditis is dependent on the response of alphabeta T lymphocytes to coxsackieviral infection. Circ Res. 1999;85:551–558
  5. Anand IS, Ganguly NK, Khanna AK, Chakravarti RN, Wahi PL. Humoral immunity in experimental immune carditis. Pathology. 1984;16:291–299
  6. Caforio AL, Grazzini M, Mann JM, et al. Identification of alpha- and beta-cardiac myosin heavy chain isoforms as major autoantigens in dilated cardiomyopathy. Circulation. 1992;85:1734–1742
  7. Caforio AL, Mahon NJ, McKenna WJ. Cardiac autoantibodies to myosin and other heart-specific autoantigens in myocarditis and dilated cardiomyopathy. Autoimmunity. 2001;34:199–204
  8. Fairweather D, Lawson CM, Chapman AJ, et al. Wild isolates of murine cytomegalovirus induce myocarditis and antibodies that cross-react with virus and cardiac myosin. Immunology. 1998;94:263–270
  9. Lowry PJ, Thompson RA, Littler WA. Humoral immunity in cardiomyopathy. Br Heart J. 1983;50:390–394
  10. Maisch B, Ristic AD, Hufnagel G, Pankuweit S. Pathophysiology of viral myocarditis: the role of humoral immune response. Cardiovasc Pathol. 2002;11:112–122
  11. O'Donoghue HL, Lawson CM, Reed WD. Autoantibodies to cardiac myosin in mouse cytomegalovirus myocarditis. Immunology. 1990;71:20–28
  12. Liu PP, Mason JW. Advances in the understanding of myocarditis. Circulation. 2001;104:1076–1082
  13. Schulze K, Becker BF, Schultheiss HP. Antibodies to the ADP/ATP carrier, an autoantigen in myocarditis and dilated cardiomyopathy, penetrate into myocardial cells and disturb energy metabolism in vivo. Circ Res. 1989;64:179–192
  14. Martin AB, Webber S, Fricker FJ, et al. Acute myocarditis. Rapid diagnosis by PCR in children. Circulation. 1994;90:330–339
  15. Why HJ, Meany BT, Richardson PJ, et al. Clinical and prognostic significance of detection of enteroviral RNA in the myocardium of patients with myocarditis or dilated cardiomyopathy. Circulation. 1994;89:2582–2589
  16. Baughman KL. Diagnosis of myocarditis: death of Dallas criteria. Circulation. 2006;113:593–595
  17. Ardehali H, Qasim A, Cappola T, et al. Endomyocardial biopsy plays a role in diagnosing patients with unexplained cardiomyopathy. Am Heart J. 2004;147:919–923
  18. Arbustini E, Gavazzi A, Dal Bello B, et al. Ten-year experience with endomyocardial biopsy in myocarditis presenting with congestive heart failure: frequency, pathologic characteristics, treatment and follow-up. G Ital Cardiol. 1997;27:209–223
  19. Hammond EH, Menlove RL, Anderson JL. Predictive value of immunofluorescence and electron microscopic evaluation of endomyocardial biopsies in the diagnosis and prognosis of myocarditis and idiopathic dilated cardiomyopathy. Am Heart J. 1987;114:1055–1065
  20. Dawson L, Talwar KK, Chopra P. Significance of pathological parameters of endomyocardial biopsy in clinical outcome of patients of dilated cardiomyopathy–II. Value of cardiac immune complexes and heart reactive antibodies. Indian Heart J. 1991;43:421–425
  21. Richardson P, McKenna W, Bristow M, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the Definition and Classification of cardiomyopathies. Circulation. 1996;93:841–842
  22. Noutsias M, Seeberg B, Schultheiss HP, Kuhl U. Expression of cell adhesion molecules in dilated cardiomyopathy: evidence for endothelial activation in inflammatory cardiomyopathy. Circulation. 1999;99:2124–2131
  23. Leon ML, Suckerman SH. Gamma interferon: a central mediator in atherosclerosis. Inflamm Res. 2005;54:395–411
  24. Herskowitz A, Ahmed-Ansari A, Neumann DA, et al. Induction of major histocompatibility complex antigens within the myocardium of patients with active myocarditis: a nonhistologic marker of myocarditis. J Am Coll Cardiol. 1990;15:624–632
  25. Wojnicz R, Nowalany-Kozielska E, Wodniecki J, et al. Immunohistological diagnosis of myocarditis. Potential role of sarcolemmal induction of the MHC and ICAM-1 in the detection of autoimmune mediated myocyte injury. Eur Heart J. 1998;19:1564–1572
  26. Frustaci A, Chimenti C, Calabrese F, Pieroni M, Thiene G, Maseri A. Immunosuppressive therapy for active lymphocytic myocarditis: virological and immunologic profile of responders versus nonresponders. Circulation. 2003;107:857–863
  27. Wojnicz R, Nowalany-Kozielska E, Wojciechowska C, et al. Randomized, placebo-controlled study for immunosuppressive treatment of inflammatory dilated cardiomyopathy: two-year follow-up results. Circulation. 2001;104:39–45
  28. Tincani A, Rebaioli CB, Taglietti M, Shoenfeld Y. Heart involvement in systemic lupus erythematosus, anti-phospholipid syndrome and neonatal lupus. Rheumatology (Oxford). 2006;45(Suppl 4):iv8–iv13
  29. Fairweather D, Frisancho-Kiss S, Njoku DB, et al. Complement receptor 1 and 2 deficiency increases coxsackievirus B3-induced myocarditis, dilated cardiomyopathy, and heart failure by increasing macrophages, IL-1beta, and immune complex deposition in the heart. J Immunol. 2006;176:3516–3524
  30. Radhakrishnan VV. Experimental myocarditis in the guinea-pig. Cardiovasc Res. 1996;31:651–654
  31. Neumann DA, Burek CL, Baughman KL, Rose NR, Herskowitz A. Circulating heart-reactive antibodies in patients with myocarditis or cardiomyopathy. J Am Coll Cardiol. 1990;16:839–846
  32. Maisch B. Immunologic regulator and effector mechanisms in myocarditis and perimyocarditis. Heart Vessels Suppl. 1985;1:209–217
  33. Afanasyeva M, Rose NR. Cardiomyopathy is linked to complement activation. Am J Pathol. 2002;161:351–357
  34. Zwaka TP, Manolov D, Ozdemir C, et al. Complement and dilated cardiomyopathy: a role of sublytic terminal complement complex-induced tumor necrosis factor-alpha synthesis in cardiac myocytes. Am J Pathol. 2002;161:449–457
  35. Banasik M, Boratynska M, Nowakowska B, et al. C4D deposition and positive posttransplant crossmatch are not necessarily markers of antibody-mediated rejection in renal allograft recipients. Transplant Proc. 2007;39:2718–2720
  36. Freese PM, Svalander CT, Molne J, Nyberg G. Renal allograft glomerulopathy and the value of immunohistochemistry. Clin Nephrol. 2004;62:279–286
  37. Figulla HR, Rahlf G, Nieger M, Luig H, Kreuzer H. Spontaneous hemodynamic improvement or stabilization and associated biopsy findings in patients with congestive cardiomyopathy. Circulation. 1985;71:1095–1104
  38. Pelliccia F, d'Amati G, Cianfrocca C, et al. Histomorphometric features predict 1-year outcome of patients with idiopathic dilated cardiomyopathy considered to be at low priority for cardiac transplantation. Am Heart J. 1994;128:316–325
  39. Prochorec-Sobieszek M, Bilinska ZT, Grzybowski J, et al. Assessment of the inflammatory process by endomyocardial biopsy in patients with dilated cardiomyopathy based on pathological and immunohistochemical methods. Kardiol Pol. 2006;64:479–487[discussion 88]
  40. Maisch B, Buschel G, Izumi T, et al. Four years of experience in endomyocardial biopsy–an immunohistologic approach. Heart Vessels Suppl. 1985;1:59–67
  41. Kuhl U, Pauschinger M, Schwimmbeck PL, et al. Interferon-beta treatment eliminates cardiotropic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation. 2003;107:2793–2798
  42. Wittchen F, Suckau L, Witt H, et al. Genomic expression profiling of human inflammatory cardiomyopathy (DCMi) suggests novel therapeutic targets. J Mol Med. 2007;85:257–271

PII: S1054-8807(09)00036-2

doi: 10.1016/j.carpath.2009.04.004

Cardiovascular Pathology
Volume 19, Issue 4 , Pages e99-e105 , July 2010

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