title: Inflammatory cell infiltrates in the heart of patients with coronary artery disease with and without inflammatory rheumatic disease: a biopsy study.
abstract: The cause of premature cardiovascular disease (CVD) in inflammatory rheumatic diseases (IRDs) has not been fully elucidated. As inflammation may play a role, we wanted to compare the occurrence and extent of inflammatory cell infiltrates (ICIs), small vessel vasculitis, and the amount of adipose tissue and collagen in cardiac biopsies taken from patients with coronary artery disease with and without IRDs.
  
  
  
  From among the Feiring Heart Biopsy Study subjects, we selected patients undergoing coronary artery bypass grafting from whom paraffin-embedded, formalin-fixed specimens from the right atrium were available. The sample comprised 48 patients with IRD and 40 non-IRD patients. Hematoxylin and eosin staining was used to examine the presence and location of ICIs and vasculitis, and Lendrum (Martius yellow, scarlet, and blue) staining was carried out for collagen and adipose tissue.
  
  
  
  Epicardial ICIs were found in 27 (56 %) patients with IRD and 24 (60 %) non-IRD patients. There were no significant differences between patients with IRD and non-IRD patients in the amount of cardiac ICIs and adipose tissue, but patients with IRD had more collagen in the myocardium than non-IRD patients. Small vessel vasculitis was not observed in any cardiac specimen. Patients with epicardial ICIs were, on average, 7 years younger than those without.
  
  
  
  Our results do not support the notion that inflammation in cardiac peri-, epi-, and myocardium plays a more important role in CVD of patients with IRD than non-IRD patients. The increased amount of collagen in the myocardium of patients with IRD suggests differences in extracellular matrix composition and/or mass, which might play a role in cardiac remodeling, and represent targets for novel therapies against heart failure.
authors.affiliation: Department of Health, Technology and Society, Norwegian University of Science and Technology (NTNU), Teknologiveien 22, 2815, Gjøvik, Norway. jacqueline.andersen@ntnu.no.
authors.forename: Jacqueline K
authors.initials: JK
authors.lastname: Andersen
authors.affiliation: Department of Pathology, Innlandet Hospital Trust, Lillehammer, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Oma
authors.affiliation: Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prayson
authors.affiliation: Department of Pathology, Innlandet Hospital Trust, Lillehammer, Norway.
authors.forename: Ingjerd Lien
authors.initials: IL
authors.lastname: Kvelstad
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway.
authors.forename: Sven Martin
authors.initials: SM
authors.lastname: Almdahl
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
authors.forename: Morten Wang
authors.initials: MW
authors.lastname: Fagerland
authors.affiliation: Hospital for Rheumatic Diseases, Lillehammer, Norway.|Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.|Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Ivana
authors.initials: I
authors.lastname: Hollan
mesh_terms: D000368:Aged; D001706:Biopsy; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010496:Pericardium / Q000473:pathology*; D012216:Rheumatic Diseases / Q000150:complications*
keywords: Cardiovascular disease; Collagen; Endocardium; Epicardial adipose tissue; Epicardium; Extracellular matrix; Inflammation; Inflammatory rheumatic diseases; Myocardium; Right atrium