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European Journal of Heart Failure 2004 6(4):389-398; doi:10.1016/j.ejheart.2003.07.010
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© 2004 European Society of Cardiology

Desmin-free cardiomyocytes and myocardial dysfunction in end stage heart failure

S. Di Sommaa,d,*, M.P. Di Benedettob, G. Salvatoreb, L. Agozzinoc, F. Ferrantia, S. Espositoc, P. La Doganad, M.I. Scaranod, G. Caputob, M. Cotrufoe, L.De Santoe and O. de Divitiisb,d

a Medical Department, II Medical School University, ‘La Sapienza’, Sant'Andrea Hospital Via di Grottarossa 1035-1039, 00186 Roma, Italy
b Department of Experimental and Clinical Medicine, University Federico II Naples, Italy
c Department of Health Medicine, Section of Pathology, Research Centre for Cardiovascular Diseases, II University of Naples Italy
d Inter-University Centre for Cardiovascular Research (G.I.M.E.C.), University of Naples Italy
e Cardiac Surgery, II University of Naples Italy

* Corresponding author. Tel.: +39-06-80345275; fax: +39-06-80345001. E-mail address: sdisomma{at}unina.it


  Abstract

Our aim was to evaluate the desmin content in the myocardial tissue of patients with end-stage heart failure of ischaemic origin and to assess its role on cardiac function. We studied 18 explanted hearts from patients transplanted for end-stage heart failure due to ischaemic cardiomyopathy (ICM). Control myocardial tissue was obtained from the cardiac biopsies of six women with breast cancer taken prior to commencing chemotherapy with anthracyclines, four male donors for heart transplantation and two autoptic hearts from patients who died due to non-cardiac events. Myocardial tissue, obtained from the left ventricle (remote zone from infarcted area), was analyzed by light and confocal immunochemistry (desmin) microscopy. The desmin content of myocardial tissue was obtained by real-time PCR. Cardiac function was evaluated by echocardiographic and right heart catheterization data, obtained before heart transplantation. Confocal microscopy evaluation showed a significant decrease in the number of desmin-positive myocytes (P<0.01) in ICM hearts compared to controls. At real-time PCR evaluation, there was a reduction (P<0.01) in desmin content in the ICM patients compared to controls. A negative correlation was found between desmin-free cardiomyocytes and ejection fraction (EF) (r=–0.834; P<0.02) on echocardiogram. A negative relationship (r=–0.688) was also found between desmin-negative myocytes and capillary wedge pressure. In conclusion, the myocardial tissue of patients with end-stage heart failure of ischaemic origin, shows a decreased number in desmin-positive myocytes at immunochemistry evaluation compared to normal individuals. This deficiency in cytoskeletal intermediate filament content is associated with reduced cardiac function.

Key Words: Heart failure • Ischaemic cardiomyopathy • Myocardium cytology • Cytoskeleton • Desmin • Myocardial function

Received November 1, 2002; Revised July 7, 2003; Accepted July 30, 2003


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