title: Right ventricular cardiomyocyte apoptosis in patients with acute myocardial infarction of the left ventricular wall.
abstract: Cardiac remodeling after acute myocardial infarction (AMI) is characterized by molecular and cellular mechanisms involving both the left (LV) and right ventricular (RV) walls. Cardiomyoycte apoptosis in the peri-infarct and remote LV myocardium has a central role in cardiac remodeling. Whether apoptosis also occurs in the right ventricle of patients with ischemic heart disease has not been investigated. The aim of the present study was to investigate the presence of cardiomyocyte apoptosis in the right ventricle in patients with AMI. We assessed the number of apoptotic cardiomyocytes using multiple samplings in the LV and RV walls of 12 patients selected at autopsy who died 4 to 42 days after AMI. Five patients without cardiac disease were also selected at autopsy as controls. Apoptotic rates were calculated from the number of cardiomyocytes showing double positive staining for in situ end-labeling of DNA fragmentation (TUNEL) and for activated caspase-3. Potentially false-positive results (DNA synthesis and RNA splicing) were excluded from cell counts. The apoptotic rate in the right ventricle in patients with AMI was significantly higher than in control hearts (median 0.8%, interquartile range 0.3 to 1.0 vs median 0.01%, interquartile range 0.01 to 0.03, p <0.001). RV apoptosis significantly correlated with such parameters of global adverse remodeling as cardiac diameter to LV free wall thickness (R = +0.57, p = 0.050). RV apoptosis was significantly higher in five cases (42%) with infarct involving the ventricular septum and an adjacent small area of the RV walls (median 1.0%, interquartile range 0.8 to 2.2 vs median 0.5%, interquartile range 0.2 to 1.0, p = 0.048, p <0.001 vs controls). The association between apoptotic rate in the right ventricle and cardiac remodeling was apparent even after exclusion of cases with RV AMI involvement (R = +0.82, p = 0.023 for diameter to LV wall thickness ratio and R = -0.91, p = 0.002 for RV free wall thickness). In conclusion, patients with cardiac remodeling after AMI had a significant increase in RV apoptosis even when ischemic involvement of the RV wall was not apparent.
authors.affiliation: Virginia Commonwealth University, Pauley Heart Center, Richmond, Virginia, USA. abbatea@yahoo.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Abbate
authors.forename: Rossana
authors.initials: R
authors.lastname: Bussani
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
authors.forename: Elena
authors.initials: E
authors.lastname: Barresi
authors.forename: Alberto
authors.initials: A
authors.lastname: Pivetta
authors.forename: Andrea
authors.initials: A
authors.lastname: Perkan
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Hoke
authors.forename: Fadi N
authors.initials: FN
authors.lastname: Salloum
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kontos
authors.forename: Giuseppe G L
authors.initials: GG
authors.lastname: Biondi-Zoccai
authors.forename: George W
authors.initials: GW
authors.lastname: Vetrovec
authors.forename: Gastone
authors.initials: G
authors.lastname: Sabbadini
authors.forename: Feliciano
authors.initials: F
authors.lastname: Baldi
authors.forename: Furio
authors.initials: F
authors.lastname: Silvestri
authors.forename: Rakesh C
authors.initials: RC
authors.lastname: Kukreja
authors.forename: Alfonso
authors.initials: A
authors.lastname: Baldi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D016022:Case-Control Studies; D005260:Female; D006346:Heart Septum / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D020287:In Situ Nick-End Labeling; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D032383:Myocytes, Cardiac / Q000473:pathology*; D020257:Ventricular Remodeling
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