CAR Expression And Significance Of Myocardial In Dilated Cardiomyopathy Of Sudden Death In Patients

Backgroud：Dilated cardiomyopathy (DCM) is a kind of unknownetiology, the main pathological changes of left ventricular cavity dilation orexpansion of bilateral chambers of the heart, with or without myocardialcontractility, diastolic dysfunction, mainly for clinical manifestations ofheart failure or heart rhythm disorders, some patients showed initialsymptoms of death, subject to forensic autopsy confirmed the sudden deathof the Department of dilated cardiomyopathy caused, so dilatedcardiomyopathy is one of the key forensic research. DCM is currentlyunknown etiology, pathogenesis is unclear, mainly genetics that viralinfections and autoimmune theory and other theories. Virus infection theoryfor most researchers recognized. On the myocardium and the relationshipbetween Coxsackie virus infection (CV) and adenovirus (ADV) expressionin the myocardium and sudden death is no more precise studies currently.Therefore, in case the diagnosis seized DCM is particularly important inforensic science research, which is to resolve medical disputes and socialstability has a positive meaning. Also check case by collecting samples for analysis in the heart of pathology, immunology and protein expression, andto explore the formation of viral infections in the role of DCM andmyocardial impact on the clinical treatment of the disease also hassignificance. Objective: Use DCM, myocarditis (MC) and normalmyocardium specimens pathology, immunology and protein expressiondetection, analysis and Coxsackie virus adenovirus infection in cardiacfunction in cases of myocardial cells. Method: This study by collecting29cases of death in patients with DCM, MC20patients died of cardiac andnon-cardiac specimens of20cases of accidental death, heart were drawnfrom each patient and is divided into10%formalin-fixed and part of theexistence of fresh specimens-80°refrigerator.10%formalin fixed tissueafter embedding, dehydration HE staining, special stains (Massontrichrome) and immunohistochemical detection of specific proteins CARanalysis;-80°refrigerator tissue to detect Coxsackie by Western blotting-adenovirus receptor expression levels of size. Research coxsackie virus andadenovirus exists in the myocardium and the corresponding expression ofthe receptor protein circumstances. Result: By studying the results of theexperiment were as follows: First, HE staining showed DCM myocardialnecrosis, myocardial hypertrophy, myocardial atrophy part, visible focalmyocardial necrosis with fibrous connective tissue proliferation obsolete;MC myocardial necrosis, myocardial interstitial lymphocytes andneutrophils infiltration, mainly lymphocytes; myocardial cell swelling part of the normal group, part of the wave myocardial degeneration; Second,special stains (Masson trichrome) visible among a large number of blueDCM myocardial interstitial fibrosis; MC and the normal group had nosignificant difference; Third, immunohistochemistry showed19cases ofDCM group and MC group of eight cases were seen red particles (AECchromogenic) deposited in the myocardium cytoplasm, no positive thanmyocardial tissue deposition of particles; immunohistochemistry imagesanalyzed by IPP software, DCM IOD group is6.646±0.155, MC groupIOD is6.206±0.326,0.123±normal group IOD is0.037, DCM group andMC group had no significant difference (P>0.05), DCM group, MC groupand normal group there are significant differences (P <0.05). Four, Westernblotting displayed CAR in DCM group and MC group were significantlyhigher. Conclusion: Research shows19cases (65.51%) of29cases ofsudden death in patients with DCM patients were examined myocardial cellatrophy, necrosis and fibrosis, myocardial fibrosis. Myocardium detectedby Western blotting to Coxsackie-adenovirus receptor expression wassignificantly higher. Therefore, part of the Department of DCM mayCoxsackie and adenovirus infection and viral replication in themyocardium of the severity of myocardial function directly determined bythe degree of fibrosis and inflammation is likely to be the cause of suddencardiac death. In addition, there are also the part of the patients withmyocardial MC coxsackievirus and adenovirus infection, which scholars DCM system before the end stage of the MC match.