title: Immunohistochemical study of remodeling of myocardial lymphatic and blood microvascular structures in terminal heart failure: differences between ischemic and dilated cardiomyopathy.
abstract: This study investigated (cardiac) remodeling of the myocardial microvasculature in patients with terminal heart failure due to ischemic (ICM) and dilative (DCM) cardiomyopathy. Seventeen transmural left-ventricular (LV) biopsies (9 ICM and 8 DCM), taken from heart transplant recipients at transplantation (n=4) or during ventricular assist device implantation (n=13) were investigated by immunohistostaining for VEGFR-1 and VEGFR-2 as capillary markers and VEGFR-3, D2-40, PROX-1 and LYVE-1 as lymphatic markers. Results were compared to LV biopsies from 7 donor hearts (control). Compared to control, DCM hearts showed a significantly higher density of LYVE-1 positive lymphatics (p < 0.05), whereas no difference was seen for other markers. ICM hearts showed a significantly higher density of D2-40 positive lymphatics (p < 0.01) and a lower density of VEGFR-2 capillaries compared to control (p < 0.05). In comparison to normal donor hearts, ICM and DCM hearts showed a significantly different pattern of microvascular receptor expression. As distinct patterns were seen in ICM and DCM, the effect of microvascular remodeling may be substantially different between two clinically important causes of cardiomyopathy. Further research should be aimed at defining the impact of extracellular matrix composition and VEGF-related angiogenesis on the myocardial microvasculature at various stages of heart failure.
authors.affiliation: Department of Cardiovascular Surgery, University Medical Centre, Freiburg, Germany. alexey.dashkevich@uniklinik-freiburg.de
authors.forename: A
authors.initials: A
authors.lastname: Dashkevich
authors.forename: W
authors.initials: W
authors.lastname: Bloch
authors.forename: A
authors.initials: A
authors.lastname: Antonyan
authors.forename: H
authors.initials: H
authors.lastname: Goebel
authors.forename: J U W
authors.initials: JU
authors.lastname: Fries
authors.forename: C
authors.initials: C
authors.lastname: Schlensak
authors.forename: F
authors.initials: F
authors.lastname: Beyersdorf
authors.forename: H J
authors.initials: HJ
authors.lastname: Geissler
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006333:Heart Failure / Q000473:pathology*; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D008208:Lymphatic System / Q000473:pathology; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology*; D025521:Tumor Suppressor Proteins / Q000032:analysis; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000032:analysis; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000032:analysis; D033921:Vesicular Transport Proteins / Q000032:analysis; D000098551:Prospero-Related Homeobox 1 Protein
chemical_list: D018398:Homeodomain Proteins; C119248:LYVE1 protein, human; D025521:Tumor Suppressor Proteins; D033921:Vesicular Transport Proteins; D000098551:Prospero-Related Homeobox 1 Protein; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2