Changes In The Microstructure Level And Cardiac Apoptosis In Cardiac Amyloidosis

Background:The amyloidoses are of a series of diseases characterized by the deposition of extracellular proteinaceous material known as amyloid., resulting in dysfunction of the organ or tissue involved. Heart is the organ that is frequently involved. It’s clinical manifestations are restrictive cardiomyopathy and congestive heart failure, sometimes with conduction block. The diagnosis relies on myocardial biopsy. In the present study about amyloidosis of nervous system and kidney, it was showed that apoptosis played an important role in its pathogenesis, and it was the principal pathway that amyloid caused damage to the tissue and cell. But to the cardiac amyloidosis, there is still no study available to evaluate whether apoptosis has the same role during causing damage to the tissue and cell.Objective:1. To investigate the structure changes in cardiac amyloidosis;2. To evaluate the level of apoptosis in the tissue of cardiac amyloidosis, and to conjecture its role in the pathogenesis of cardiac amyloidosis.Method:Chose6patients who was definitely diagnosed as cardiac amyloidosis as the case group, and chose3patients with normal cardiac function as control group. And finish the following examination:1. To observe the ultrastructural change using electron microscope;2. To evaluate the microstructural change using HE stain and Masson stain;3. To evaluate the level of apoptosis using the TUNEL method and caspase-3immunohistochemical stain.Result:1. Electron microscope observation shows intracellular fiber disorder, glycogen reserves decrease, and mitochondrial swelling and degeneration;2. The analysis of the HE stain image using image processing software shows that, the case group compared with the control group, the quantity of myocardial cell is significantly decreased, and the size of cell is significantly increased;3. The analysis of the Masson stain image using image processing software shows that, the case group compared with the control group, the degree of intercellar fibrosis is significantly higher;4. The analysis of TUNELmethod and caspase-3immunohistochemical stain shows that, the case group compared with the control group, the level of apoptosis is significantly increased.Conclusion:1. There are significant abnormalities of myocardial cell size, quantity andstructure in the cardiac amyloidosis, simultaneously associated with the increased degree of intercellular fibrosis.2. The level of apoptosis in the cardiac amyloidosis is significantly increased.