α1-adrenoceptor Expression And Significance Of Myocardiai In Pheochromocytoma Of Death In Patients

Phaeochromocytomas are rare catecholamine-producingtumors that arise from chromaffin cells of the adrenal medulla andextra-adrenal sites. The incidence is0.1%ofhypertensive individuals. Sporadic forms of phaeochromocytoma areusually diagnosed in individuals aged40-50years female. Clinicalpresentation of phaeochromocytoma can vary greatly and it istherefore often referred to as the great mimic. Clinical presentation ofphaeochromocytoma include severe hypertension， hypotension（shock），headaches，palpitation，sweaty，cold diaphoresis, nausea,and vomiting，chest pains，abdominal cramps and cyansis. Some rareclinical presentation coverpersistent hiccups，coughed up fresh blood. Some case of suddendeath due to a phaeochromocytoma in an apparently healthy youngman who have asymptomatic is presented. The usual clinical findingsof recurrent episodes of headache, palpitation and perspiration arewell known. The clinic expression of Pheochromocytoma is highly varable andeasy to be confused with many other disorders displaying similarmanifestations，thus the tumour might not be detected, resulting in avery low diagnosis ratio.An acute hypertensive crisis, caused by the hitherto unknownpheochromocytoma was ascertained as the cause of death.Themorphological findings are presented, the difficulty to diagnosepheochromocytoma and the medico-legal implications are discussed.Most of paper on Pheochromocytoma are focus on clinicalpresentation， medical diagnosis,differential diagnosis,laboratoryexamination,therapies and so on.Research for catecholaminehormones, found in impaction of adrenaline on isolated vascularsmooth muscle cell structure and function. While system pathology,laboratory examination, analysis the relationship between injuries anddisease are few.This paper is based on the above background expandexploration and research.Objective: By comparing the pathologicalchanges, immunohistochemistry results of myocardium who Deathsdue to pheochromocytoma,essential hypertension,accident or high fallthose who use epinephrine during cardiopulmonary resuscitation andhealthy.To analysis and comparison:1. Catecholamines hypertensionand essential hypertension myocardial pathological changes of thesimilarities and differences;2.On myocardial pathological changes of exogenous and endogenous epinephrine.Method: In this study,collected6deaths suffering from pheochromocytoma， essentialhypertension,accident or high fall those who use epinephrine duringcardiopulmonary resuscitation and healthy respectively.Heart weredrawn from each patient and is divided into10%formalin-fixed，afterembedding, dehydration HE staining, special stains (Massontrichrome) and immunohistochemical detection of specificα1-adrenoceptor analysis.Analysis of catecholamine hormones affectcardiac structure and function.Result:HE staining showedcardiomyocyte hypertrophy，acute myocardial ischemic changes，Cardiomyocytes spotty necrosis, hemorrhage with inflammatory cellinfiltration， Myocardial interstitial fibrous connective tissuehyperplasia with mild inflammatory cell infiltration，small arterybetween cardiomyocyte sstenosis， intimal thickening， hyalinedegeneration， muscle degeneration and fibrinoid necrosis.Specialstaining showed whose collagen production increased in myocardialinterstitial and vascular wall suffered from pheochromocytoma oressential hypertension than control group.Immunohistochemistryshowed α1-adrenergic receptor on cardiomyocyt who sufferedpheochromocytoma or essential hypertension esexpressed more thancontrol group， while there is difference between the twogroups.Conclusion：|Patients with pheochromocytoma collagen production increased among myocardial interstitial. Concerned withcardiac hypertrophy, decreased cardiac contractility, ejection fractionlower.α1-adrenergic receptor on cardiomyocyt who sufferedpheochromocytoma or essential hypertension esexpressed more thancontrol group.Increased α1-AR promote myocardial blood vessels andlead myocardial ischemia.