Schacherer C, Koops D, Wiemer J, Hartmann A, Weis M, Klepzig H, Zeiher A M, Olbrich H G
J.W. Goethe University, Department of Medicine, Frankfurt, Germany.
Int J Cardiol. 1999 Jan;68(1):115-20. doi: 10.1016/s0167-5273(98)00341-6.
Following heart transplantation remodeling of the donor heart causes changes in the extracellular myocardial matrix. We investigated 20 right ventricular endomyocardial biopsies taken 17+/-4 days (group I, n=9) and 63+/-13 days (group II, n=11) after heart transplantation from 16 patients transplanted for end-stage cardiomyopathy (15 dilated/1 ischemic). Immunohistochemical staining for collagen I, collagen III, collagen IV, and fibronectin was used. Evaluation was performed at a magnification of 400x using a computer-assisted image analyzing system measuring the relative area stained by the immunoperoxidase method, the number of cells in the given area, and the total area. Collagen I per cell was 13.9+/-5.9 microm2 in group I and increased significantly 66+/-13 days after heart transplantation in the perimysium around the myocardial cells as well as in the endocardium to 49.9+/-15.1 microm2 (P<0.05). No quantitative change in collagen III was noted (75.7+/-12.4 versus 75.5+/-16.0 microm2 n.s.). Collagen IV was found in the perimysial, in the capillary bed and in the vascular network. Significant quantitative change in the amount of collagen IV was not found (64.1+/-12.6 versus 61.0+/-8.9 microm2). Fibronectin was found in the entire perimysial extracellular matrix and in the endocardium in relationship with collagen I and III. An increased amount of fibronectin from 87.09+/-9.9 microm2 (group I) to 140.8+/-17.9 microm2 (group II, P<0.05) was found. The cell area and cell diameters were not significantly different (group I; cell area 772+/-227 microm2, diameter 31.3 microm; group II; cell area 776+/-224 microm2, diameter 31.4 microm). It is concluded that remodeling of the donor heart after transplantation is characterized by a specific increase in collagen I and fibronectin, whereas a change in other collagen subtypes was not observed.
心脏移植后，供体心脏的重塑会导致心肌细胞外基质发生变化。我们对16例因终末期心肌病（15例扩张型/1例缺血型）接受心脏移植的患者进行了研究，分别在移植后17±4天（I组，n = 9）和63±13天（II组，n = 11）采集了20份右心室心内膜活检样本。采用免疫组织化学方法对I型胶原、III型胶原、IV型胶原和纤连蛋白进行染色。使用计算机辅助图像分析系统在400倍放大倍数下进行评估，测量免疫过氧化物酶法染色的相对面积、给定区域内的细胞数量以及总面积。I组中每个细胞的I型胶原面积为13.9±5.9平方微米，心脏移植后66±13天，心肌细胞周围的肌束膜以及心内膜中的I型胶原显著增加至49.9±15.1平方微米（P<0.05）。未观察到III型胶原的定量变化（75.7±12.4对75.5±16.0平方微米，无统计学差异）。IV型胶原存在于肌束膜、毛细血管床和血管网络中。未发现IV型胶原含量的显著定量变化（64.1±12.6对61.0±8.9平方微米）。纤连蛋白存在于整个肌束膜细胞外基质以及与I型和III型胶原相关的心内膜中。发现纤连蛋白的含量从87.09±9.9平方微米（I组）增加到140.8±17.9平方微米（II组，P<0.05）。细胞面积和细胞直径无显著差异（I组；细胞面积772±227平方微米，直径31.3微米；II组；细胞面积776±224平方微米，直径31.4微米）。结论是，移植后供体心脏的重塑特征为I型胶原和纤连蛋白特异性增加，而未观察到其他胶原亚型的变化。
