Cardiovascular Pathology最新文献

英文中文

Mitral Isthmus anatomy: Detailed examination and classification proposal 二尖瓣峡解剖：详细检查和分类建议。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-30 DOI: 10.1016/j.carpath.2025.107723

Buse Naz Çandır Gürses , Kader Yılar , Çağla Ergin , Özcan Gayretli

Aim

The aim of this study was to investigate the anatomical features of the mitral isthmus (MI) line, the vessels located there and their localisation in the MI line.

Methods

MI length and wall thickness were measured in a total of 65 autopsied fresh hearts. The distances of the vessels at the level of MI to the left inferior pulmonary vein (LIPV), mitral annulus (MA), endocardium surface (ES) and lateral adipose tissue (LAT) were recorded.

Results

The mean linear length of MI and left atrial wall thickness were 49.6 ± 9.9 mm and 3.9 ± 1.2 mm, respectively. GCV and LCx are approximately 1 cm from MA, 4 cm from LIPV, 5-6 mm from ES and 7 mm from LAT. Great cardiac vein (GCV) was found to be located in the MI line in 100 %, left circumflex artery (LCx) in 60 %, and vein of Marshall (VOM) in 63.1 % of cases. Presence of only GCV was recorded as Type-1 (18.5 %), GCV and LCx as Type-2 (18.5 %), GCV and VOM as Type-3 (21.5 %) and presence of all three as Type-4 (41.5 %). LCx located below the GCV was recorded as Type-A (59 %), above the GCV as Type-B (25.6 %), and at the same level but with LCx on the endocardial surface as Type-C1 (12.8 %) and on the epicardial surface as Type-C2 (2.6 %).

Conclusion

This study proves that the anatomy of MI is far from standardised and helps to raise awareness of the vascular pattern that may be encountered prior to ablation intervention.

目的：本研究的目的是探讨二尖瓣峡（MI）线的解剖特征，位于那里的血管及其在MI线的定位。方法：测定65例新鲜解剖心脏心肌梗死长度和壁厚。记录心肌水平血管到左下肺静脉（LIPV）、二尖瓣环（MA）、心内膜表面（ES）和外侧脂肪组织（LAT）的距离。结果：心肌梗死线长平均49.6±9.9 mm，左房壁厚度平均3.9±1.2 mm。GCV和LCx距MA约1厘米，距LIPV约4厘米，距ES约5-6毫米，距LAT约7毫米。心脏大静脉（GCV）位于心肌梗死线（100%），左旋动脉（LCx）位于心肌梗死线（60%），马歇尔静脉（VOM）位于心肌梗死线（63.1%）。仅GCV为1型（18.5%），GCV和LCx为2型（18.5%），GCV和VOM为3型（21.5%），三者均为4型（41.5%）。位于GCV下方的LCx为a型（59%），位于GCV上方的LCx为b型（25.6%），位于相同水平但心内膜表面的LCx为c1型（12.8%）和心外膜表面的LCx为c2型（2.6%）。结论：本研究证明心肌梗死的解剖结构远未标准化，有助于提高对消融介入前可能遇到的血管形态的认识。

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引用次数: 0

Seasonal variation of unexpected sudden cardiac death in northern Finland 芬兰北部意外心源性猝死的季节变化。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-28 DOI: 10.1016/j.carpath.2025.107725

Severi M Mattila , Hanna Latola , Lasse Pakanen , Jenni J Hekkanen , M Anette E Eskuri , Juha Vähätalo , Olavi H Ukkola , M Juhani Junttila , Heikki V Huikuri , Juha S Perkiömäki

Background

Data on the occurrence of unexpected sudden cardiac death (SCD) in different seasons are limited.

Methods

All unexpected sudden death victims have to undergo medico-legal autopsy obligated by the Finnish law. Consecutive series of all unexpected autopsied SCD victims (n = 5,869) were prospectively collected from the geographically defined area in the Northern Finland during a twenty years period from 1998 to 2017. We evaluated the seasonal variation of SCD and its possible causes.

Results

Unexpected SCD occurred more frequently during the first quarter of a year (from January to March) than during the other quarters. The occurrence of SCD during the twenty years follow-up was 4.5 ± 0.24 during the first quarter of the year per month and 3.9 ± 0.12 during the other quarters of the year per month on average (SCDs during the quarter of a year per month on average per 100,000 inhabitants per year, p < 0.001). The weather was colder during the first quarter of the year (average temperature -9.1 degrees centigrade) than during the other quarters (average temperature +5.7 degrees centigrade). The subjects who experienced SCD during the first quarter of the year had more commonly severe (75 %-90 %) coronary artery stenosis, (p < 0.001).

Conclusion

Unexpected SCD occurred more commonly during the first quarter of a year (from January to March) than during the other quarters (from April to December). Cold weather with its physiological consequences and more severe coronary artery disease predisposing to ischemia may have contributed to the increased occurrence of SCD during the first quarter of the year.

背景：不同季节发生意外心源性猝死（SCD）的数据有限。方法：所有意外猝死的受害者都必须接受芬兰法律规定的法医尸检。在1998年至2017年的20年间，前瞻性地从芬兰北部地理上确定的区域收集了所有意外尸检的SCD受害者（n= 5869）的连续系列。我们评估了SCD的季节变化及其可能的原因。结果：1 - 3月第一季度意外SCD的发生频率高于其他季度。20年随访期间SCD的平均发生率为每年第一季度（4.5±0.24）例/月，其他季度（3.9±0.12）例/月（平均每10万人/年）。结论：每年第一季度（1 - 3月）意外SCD的发生率高于其他季度（4 - 12月）。寒冷的天气及其生理后果和更严重的冠状动脉疾病易导致缺血，可能是今年第一季度SCD发病率增加的原因。

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引用次数: 0

COVER 4: Table of Contents/Barcode PMS 200 封面4：目录/条形码PMS 200

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-27 DOI: 10.1016/S1054-8807(25)00007-9

引用次数: 0

COVER 3: Editorial Board 封面3：编辑委员会

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-27 DOI: 10.1016/S1054-8807(25)00006-7

引用次数: 0

Patent foramen ovale: A variant of normal or a true congenital heart disease? 卵圆孔未闭：正常的变异还是真正的先天性心脏病？

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-22 DOI: 10.1016/j.carpath.2025.107722

Stefania Rizzo, Monica De Gaspari, Cristina Basso, Chiara Fraccaro, Gaetano Thiene

Foramen ovale plays a key role in foetal circulation, however it may remain patent after birth throughout the life. Its patency is so frequent in healthy people (27-35 %), such as to be considered a variant of normal. It is at risk of complications, like paradoxical embolism by right to left shunt with stroke, migraine, temporary blindness, as well as aneurysm, thrombosis and endocarditis of the fossa ovalis. There is no doubt that it should be considered a congenital heart disease at all effects. Invasive cardiology closure with umbrella and even with stiches is nowadays feasible and indicated in specific clinical scenarios. Further research is needed to determine whether cardiac echo-doppler screening for identifing affected patients as a primary prevention measure is advisable.

卵圆孔在胎儿循环中起着关键作用，但它在出生后可能一直未闭。它在健康人群中如此常见（27-35%），以至于被认为是正常的变体。它有并发症的风险，如由右至左分流引起的矛盾栓塞伴中风、偏头痛、暂时性失明，以及动脉瘤、血栓形成和卵窝心内膜炎。毫无疑问，它应该被认为是一种先天性心脏病。有创心脏闭合伞，甚至缝线是目前可行的，并指出在特定的临床情况。需要进一步的研究来确定心脏超声多普勒筛查作为一种一级预防措施是否可取。

引用次数: 0

Intimal sarcoma of the lower pulmonary vein diagnosed by Endobronchial Ultrasound-Guided Fine-Needle Aspiration (EBUS-FNA): A case report and comprehensive literature review 支气管超声引导下细针穿刺诊断下肺静脉内膜肉瘤1例并文献复习。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-15 DOI: 10.1016/j.carpath.2025.107717

H. Elmas , I. Kholová , S. Meierling , L. Welker

Intimal sarcoma of blood vessels is a rare, aggressive tumor originating from vascular endothelial cells. This report presents a 22-year-old male diagnosed with an intimal sarcoma of the lower pulmonary vein, detailing diagnosis, treatment, and prognosis information. Additionally, this report explores the application application of Endobronchial Ultrasound-Guided Fine-Needle Aspiration (EBUS-FNA) alongside with Rapid Remote Online Evaluation (ROLE) for identifying a mass-like lesion in the pulmonary vein. We emphasize the value of this technique for supporting ancillary studies like immunohistochemistry. The importance of accurate diagnostic methods and personalized treatment management to improve prognosis in rare cancers is highlighted by this thorough analysis.

摘要血管内膜肉瘤是一种罕见的侵袭性肿瘤，起源于血管内皮细胞。本文报告一位22岁男性，诊断为下肺静脉内膜肉瘤，详细介绍了诊断、治疗和预后信息。此外，本报告探讨了支气管超声引导下细针穿刺（EBUS-FNA）与快速远程在线评估（ROLE）在识别肺静脉肿块样病变中的应用。我们强调该技术在辅助研究如免疫组织化学方面的价值。准确的诊断方法和个性化的治疗管理对改善罕见癌症的预后的重要性是通过这一深入的分析。

引用次数: 0

An autopsy case of TFE3-rearranged PEComa-like neoplasm with systematic embolization involving the heart tfe3重排pecoma样肿瘤伴系统性栓塞累及心脏的尸检病例。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-08 DOI: 10.1016/j.carpath.2025.107715

Ikoi Omatsu , Hiroki Mukai , Toshifumi Doi , Takeshi Ishikawa , Yoshito Itoh , Eiichi Konishi , Yukiko Shishido-Hara

A rare autopsy case of malignant transcription factor E3 (TFE3)-rearranged perivascular epithelioid cell tumor (PEComa)-like neoplasm is presented. An 84-year-old woman manifested multiple cerebral infarctions and repetitive embolic events in the supra mesenchymal artery (SMA), and the presence of a mobile mass in the heart's left ventricle was also revealed. Tumoral lesions were also found in a pelvic space and a right pleural cavity, and a biopsy was performed from one of the disseminated tumor masses in the right pleura. Pathological diagnosis of TFE3-rearranged PEComa-like neoplasm was defined based on the evidence of partial expression of Melan A, and strong nuclear expression of TFE3 and by detection of the Xp11.2 locus split signal with FISH. A post-mortem analysis via autopsy revealed the widespread intravascular tumors in the heart's left ventricle, supra mesenchymal vein (SMV), and partial vein. The left intraventricular tumoral mass was associated with thrombus and fibrine, and thrombotic emboli were also found in SMA, SMV, and left pulmonary arteries. Interestingly, organ-based tumor invasion accompanying desmoplastic reactions was hardly seen. The small intestine was perforated, likely due to ischemia, which resulted in suppurative peritonitis and sepsis. This was thought of as the direct cause of death.

This is the first report of a precise autopsy investigation of TFE3-rearranged PEComa-like neoplasm. Tumoral localization was mostly intravascular or disseminative in the pleural cavity. Given the limited understanding of this tumoral pathophysiology, this case offers valuable insights for prompt diagnosis and effective treatment strategies.

报告一例罕见的恶性转录因子E3 (TFE3)-重排血管周围上皮样细胞瘤（PEComa）样肿瘤。一位84岁的女性表现为多发性脑梗死和间质上动脉（SMA）反复栓塞事件，并在心脏左心室发现了一个可移动的肿块。在骨盆间隙和右胸膜腔也发现了肿瘤病变，并对右胸膜的一个弥散性肿瘤肿块进行了活检。根据Melan A的部分表达和TFE3的强核表达，以及FISH检测Xp11.2位点分裂信号，确定TFE3重排pecoma样肿瘤的病理诊断。尸检结果显示，左心室、间质上静脉（SMV）和部分静脉血管内肿瘤广泛存在。左侧脑室内肿瘤肿块与血栓和纤维纤维相关，SMA、SMV和左肺动脉也发现血栓性栓塞。有趣的是，以器官为基础的肿瘤侵袭伴结缔组织增生反应几乎未见。小肠穿孔，可能是由于缺血，导致化脓性腹膜炎和败血症。这被认为是死亡的直接原因。这是对tfe3重排的pecoma样肿瘤进行精确解剖调查的第一份报告。肿瘤多位于血管内或胸膜腔内。鉴于对这种肿瘤病理生理的了解有限，本病例为及时诊断和有效治疗策略提供了有价值的见解。

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引用次数: 0

Mast cells and arteriogenesis: A systematic review 肥大细胞与动脉发生：系统综述。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-06 DOI: 10.1016/j.carpath.2025.107716

Alice Nassar , Elizabeth Wagura , Marios Loukas

Vascular occlusive diseases remain a major health burden worldwide, necessitating a deeper understanding of the adaptive responses that mitigate their impact. Arteriogenesis, the growth and remodeling of collateral vessels in response to arterial occlusion, is a vital defense mechanism that counteracts fluid shear stress-induced vascular stenosis or occlusion. While physical factors driving arteriogenesis have been extensively studied, the specific cellular mediators involved are poorly understood. Notably, the role of innate and adaptive immune cells, particularly mast cells, in arteriogenesis has received limited attention. This systematic review bridges this knowledge gap by investigating the contribution of mast cells to vascular cell proliferation and leukocyte recruitment in arteriogenesis. A comprehensive search of major databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines reveals the critical connection between mast cells, inflammatory cells, innate immune cells, and growth factors in arteriogenesis. Our findings highlight the molecular mechanisms of mast cell activation, sheer stress exertion, and pro-arteriogenic growth factor recruitment. Furthermore, we explore the endogenous and exogenous factors, including nitrite, dipyridamole, thrombin, and cobra venom, triggering mast cell-mediated release of pro-arteriogenic factors. Additionally, we examine the impact of recombinant parathyroid hormone (rPTH) therapy on mast cell numbers and arteriogenesis in bone defect and allograft healing. Our review provides compelling evidence for the pro-arteriogenic role of mast cells, particularly during the early inflammatory phase of vessel occlusion, suggesting that targeting mast cell activation may be a promising therapeutic strategy for enhancing arteriogenesis and treating ischemia-related diseases.

血管闭塞性疾病仍然是世界范围内的一个主要健康负担，需要更深入地了解减轻其影响的适应性反应。动脉发生，即侧支血管在动脉闭塞时的生长和重塑，是一种重要的防御机制，可以抵消流体剪切应力引起的血管狭窄或闭塞。虽然驱动动脉发生的物理因素已被广泛研究，但所涉及的特定细胞介质却知之甚少。值得注意的是，先天和适应性免疫细胞，特别是肥大细胞，在动脉形成中的作用受到的关注有限。本系统综述通过研究肥大细胞在动脉形成过程中对血管细胞增殖和白细胞募集的贡献，弥合了这一知识差距。使用首选报告项目对主要数据库进行全面搜索，以进行系统评价和荟萃分析指南，揭示了肥大细胞、炎症细胞、先天免疫细胞和动脉发生中生长因子之间的关键联系。我们的研究结果强调了肥大细胞活化、应激作用和促动脉生成生长因子募集的分子机制。此外，我们探讨了内源性和外源性因素，包括亚硝酸盐、双嘧达莫、凝血酶和眼镜蛇毒液，触发肥大细胞介导的促动脉生成因子的释放。此外，我们研究了重组甲状旁腺激素（rPTH）治疗对骨缺损和同种异体移植愈合中肥大细胞数量和动脉发生的影响。我们的综述为肥大细胞的促动脉生成作用提供了令人信服的证据，特别是在血管闭塞的早期炎症阶段，这表明靶向肥大细胞激活可能是一种有希望的治疗策略，可以促进动脉生成和治疗缺血相关疾病。

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引用次数: 0

Sudden death in a case of triple-vessel, non-atherosclerotic, diffuse ectasia and aneurysmal dilatations of the coronary arteries: An autopsy report 猝死病例三支血管，非动脉粥样硬化，弥漫性扩张和动脉瘤状冠状动脉扩张：尸检报告。

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2025-01-02 DOI: 10.1016/j.carpath.2024.107714

Shatishraj Jothee , Zhao Peng Koo , Mary N. Sheppard , Tuan Minanoriah binti Tuan Muda

Aneurysmal Coronary Artery Disease (ACAD) can occur as localized dilations of a segment of one or more coronary arteries or diffuse ectasia-type dilatations of one or more coronaries. Atherosclerosis remains the most common cause of these aneurysms, with Kawasaki Disease being implicated in the Asian population. We present a case of a 62-year-old Asian woman who dies suddenly with no prior symptoms. and underwent an autopsy. Her heart showed diffuse aneurysmal dilatations of the epicardial coronary arteries, with a giant saccular aneurysm of the left main coronary artery. Histopathology revealed medial degeneration of the aneurysmal wall with no evidence of atheroma or vasculitis. Following a review of the pathological causes of coronary aneurysms, it is likely that the cause of such diffuse dilatations of the coronaries could be previous vasculitis such as Kawasaki disease.

动脉瘤性冠状动脉疾病（ACAD）可发生在一个或多个冠状动脉的局部扩张或一个或多个冠状动脉的弥漫性扩张型扩张。动脉粥样硬化仍然是这些动脉瘤最常见的原因，川崎病与亚洲人群有关。我们提出一个62岁的亚洲妇女谁突然死亡没有先前的症状。并接受了尸检。她的心脏显示心外膜冠状动脉弥漫性动脉瘤扩张，左冠状动脉主动脉有一个巨大的囊状动脉瘤。组织病理学显示动脉瘤壁内侧变性，无动脉粥样硬化或血管炎。根据对冠状动脉瘤病理原因的回顾，冠状动脉弥漫性扩张的原因可能是先前的血管炎，如川崎病。

引用次数: 0

Rapid versus slow degeneration and complications of biomaterials in patients with congenital heart disease 先天性心脏病患者生物材料的快速与缓慢变性及并发症

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology

Pub Date : 2024-12-31 DOI: 10.1016/j.carpath.2024.107712

Armin Darius Peivandi , Michael Holtkamp , Hennes Rave , Lars Linsen , Sven Martens , Klaus-Michael Müller , Uwe Karst , Sabrina Martens

Objectives

Re-operations due to material degeneration carry a burden for patients with congenital heart disease (CHD). The study aim was to compare rapid vs. slow degeneration of biomaterials in CHD patients.

Methods

Explants from re-operations of 29 CHD patients (2015-2022) were grouped according to the duration of implantation (short implantation < 3 years (n = 16) vs. long implantation 10-15 years (n = 13)). Histologic processing and staining allowed tissue and calcification analysis. Micro-X-ray fluorescence (µXRF) was used for elemental analysis. Semi-quantitative comparison of calcium was conducted using a self-developed software.

Results

Thrombosis was recurrently observed in short-implanted RVOT samples. 62.5 % (n = 10) of short-implanted samples showed calcification in Alizarin red staining, in comparison to 69.2 % (n = 9) in the long-implanted group. µXRF analysis revealed calcium deposits in all patients, mostly co-localized with phosphorus. In the short implant group, other detected elements included iron, chlorine, chromium, nickel, titanium and zinc. In the long implant group, iron, nickel, titanium, zinc, copper and iodine were found. No significant difference in calcification (Ca-Si-ratio) between both implantation groups (p = 0.083) was found.

Conclusion

Thrombus formation is a main rapid degeneration cause in the RVOT. Deteriorations of biomaterials in CHD patients show strong parallels to bioprosthetic valve degenerations. Early calcification in young patients is supported by our semi-quantitative calcium analysis. The role of other elements in graft degeneration remains to be assessed in the future.

目的：先天性心脏病（CHD）患者因材料变性而再次手术的负担很重。研究旨在比较先天性心脏病（CHD）患者生物材料的快速退化与缓慢退化：29例CHD患者（2015-2022年）再次手术的切片根据植入时间分组（短期植入<3年（16例）与长期植入10-15年（13例））。通过组织学处理和染色，可以对组织和钙化进行分析。微X射线荧光（µXRF）用于元素分析。使用自行开发的软件对钙进行半定量比较：结果：在短时间内植入的 RVOT 样品中反复观察到血栓形成。在茜素红染色中，62.5%（n=10）的短植入样本出现钙化，相比之下，长植入组的钙化率为 69.2%（n=9）。µXRF分析显示，所有患者都有钙沉积，大部分与磷共定位。在短种植体组中，检测到的其他元素包括铁、氯、铬、镍、钛和锌。在长种植体组中，发现了铁、镍、钛、锌、铜和碘。两组植入物在钙化（钙硅比）方面无明显差异（P=0.083）：结论：血栓形成是 RVOT 快速退化的主要原因。结论：血栓形成是 RVOT 快速退化的主要原因，心脏病患者的生物材料退化与生物人工瓣膜退化有很大相似之处。我们的半定量钙分析支持年轻患者的早期钙化。其他因素在移植物退化中的作用仍有待今后评估。

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