title: Pathohistological Evidence of Smoldering Inflammation in Rheumatic Heart Disease with Massive Left Atrial Calcification.
abstract: A 74-year-old man, who had a history of a mitral valve replacement for rheumatic heart disease (RHD) 30 years previously, was admitted with progressive heart failure. Massive calcification was observed around the left atrium on multidetector CT, in addition to a late gadolinium enhancement (LGE)-positive layer adjacently outside of the calcification on MRI. He underwent a second mitral valve replacement for the prosthetic valve failure. Pathohistological analyses of a tissue section of the left atrial wall from a surgical specimen revealed lymphocyte and macrophage infiltration that coincided with the LGE-positive layer on MRI, suggesting the existence of sustained active inflammation even after the long period of RHD.
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Shiba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sugano
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Hatsue
authors.initials: H
authors.lastname: Ishibashi-Ueda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ohara
authors.forename: Takuya
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D004417:Dyspnea / Q000209:etiology / Q000473:pathology*; D005682:Gadolinium; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000473:pathology; D006349:Heart Valve Diseases / Q000473:pathology*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012214:Rheumatic Heart Disease / Q000150:complications / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D005682:Gadolinium