[The expression of proliferating cell nuclear antigen and alpha smooth muscle actin in papillary muscles of the patient with rheumatic heart disease and its significance].
OBJECTIVE
To reveal the change of chronic rheumatic cardiomyocyt phenotype and its relationship with myocardium fibrosis.


METHODS
The papillary muscles samples were obtained from patients with rheumatic heart disease during mitral valve replacement. Normal papillary muscles samples obtained from adult and fetal heart during autopsy in control group. The specimens were examined using immunohistochemistry and immunoelectron microscopy observation with monoclonal antibody of antiproliferating cell nuclear antigen (PCNA) and anti-alpha smooth muscles actin (alpha-SMA), and imaging analysis was performed.


RESULTS
The interstitial fibrosis (24.7% +/- 3.05%) and the ratio between inner and outer diamater of arteriolas (0.405 +/- 0.035) in rheumatic myocardium were higher significantly than those in normal myocardium. Immunohistochemical PCNA expression was not only in interstitial but also in hypertrophic cardiomyocytes of rheumatic heart disease. The positive expression in rheumatic myocardium increased. There were a lot of rough endoplasmic reticula, ribosomes and Golgi bodies in cytoplasm of PCNA and alpha-SMA positive cells. The degree of PCNA and alpha-SMA positive expression was increased with enlargement of fibrosis areas.


CONCLUSIONS
There is not only a high expression of PCNA and alpha-SMA in the myocardium of patients with rheumatic heart disease but also in fetal myocardium. We suggested that pathological myocardial cells are constructive phenotype and synthetive phenotype. PCNA and alpha-SMA positive expression cells are in the proliferating stage, they take part in fibrotic progress and vascular reconstruction in the myocardium.
Department of Cardiothoracic Surgery, Xijing Hospital, Fourth Military Medical University, Xian.
J
J
Zhang
W
W
Liu
P
P
Yan
D000328:Adult; D005260:Female; D005355:Fibrosis; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008840:Microfilament Proteins / Q000096:biosynthesis*; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000378:metabolism; D009206:Myocardium / Q000473:pathology; D010210:Papillary Muscles / Q000378:metabolism* / Q000473:pathology; D018809:Proliferating Cell Nuclear Antigen / Q000096:biosynthesis*; D012214:Rheumatic Heart Disease / Q000378:metabolism*
D008840:Microfilament Proteins; D018809:Proliferating Cell Nuclear Antigen