肺炎衣原体密度在退行性主动脉瓣狭窄的纤维化和钙化区域增加。

Density of Chlamydia pneumoniae is increased in fibrotic and calcified areas of degenerative aortic stenosis.

作者信息

Pierri Humberto, Higuchi-dos-Santos Marilia Harumi, Higuchi Maria de Lourdes, Palomino Sueli, Sambiase Nadia Vieira, Demarchi Lea Maria M, Rodrigues Giselle Helena de Paula, Nussbacher Amit, Ramires José Antonio Franchini, Wajngarten Mauricio

机构信息

Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.

出版信息

Int J Cardiol. 2006 Mar 22;108(1):43-7. doi: 10.1016/j.ijcard.2005.04.022. Epub 2005 May 31.

DOI:10.1016/j.ijcard.2005.04.022

PMID:15925417

Abstract

BACKGROUND

The process of aortic degeneration associated with calcified aortic stenosis shares many similarities with coronary artery atherosclerosis. Inflammation and infection are involved in both diseases. Chlamydia pneumoniae has been identified in atherosclerotic plaques. However, the studies about the presence of C. pneumoniae in degenerative aortic stenotic valves are not conclusive.

OBJECTIVE

We investigated whether an association exists between the density of C. pneumoniae and fibrosis or calcification in aortic stenosis.

DESIGN

Autopsy and surgical specimens were divided into 3 groups: Normal, 11 normal autopsy valves Atherosclerosis, 10 autopsy valves from patients with systemic atherosclerosis and no aortic stenosis and Aortic stenosis, 14 surgical specimens of aortic valves replaced due to aortic stenosis.

SETTING

Heart Institute (InCor), University of São Paulo Medical School.

PATIENTS

Aortic valves from patients aged 52+/-16 years, 69+/-9 years, and 71+/-8 years.

INTERVENTION

Specimens were evaluated by immunohistochemical technique (to detect C. pneumoniae antigens), in situ hybridization, and electron microscopy (to quantify the density of C. pneumoniae in the valves).

MEASUREMENTS

The aortic stenosis group was analyzed according to 3 subregions: aortic stenosis-preserved, peripheral preserved regions; aortic stenosis-fibrosis, peri-calcified fibrotic tissue; and aortic stenosis-calcification, calcified nodules.

RESULTS

The median values of C. pneumoniae antigens were 0.09, 0.30, 0.18, 1.33, and 3.3 in groups Normal, Atherosclerosis, Aortic stenosis-preserved, Aortic stenosis-fibrosis, and Aortic stenosis-calcification, respectively. The amount of C. pneumoniae was greater in the Atherosclerosis and Aortic stenosis-calcification groups than in the Normal group (P<0.05). C. pneumoniae was greater in the Aortic stenosis group in the calcified and fibrotic regions than in preserved region (P<0.05).

CONCLUSION

An association was found between the higher density of C. pneumoniae and fibrosis/calcification in stenotic aortic valves.

摘要

背景

与钙化性主动脉瓣狭窄相关的主动脉退变过程与冠状动脉粥样硬化有许多相似之处。炎症和感染在这两种疾病中都有涉及。肺炎衣原体已在动脉粥样硬化斑块中被发现。然而，关于肺炎衣原体在退行性主动脉狭窄瓣膜中存在情况的研究尚无定论。

目的

我们研究了肺炎衣原体密度与主动脉狭窄中的纤维化或钙化之间是否存在关联。

设计

尸检和手术标本分为3组：正常组，11个正常尸检瓣膜；动脉粥样硬化组，10个来自患有全身性动脉粥样硬化但无主动脉狭窄患者的尸检瓣膜；主动脉狭窄组，14个因主动脉狭窄而置换的主动脉瓣膜手术标本。

地点

圣保罗大学医学院心脏研究所（InCor）。

患者

年龄分别为52±16岁、69±9岁和71±8岁患者的主动脉瓣膜。

干预

通过免疫组织化学技术（检测肺炎衣原体抗原）、原位杂交和电子显微镜（量化瓣膜中肺炎衣原体的密度）对标本进行评估。

测量

主动脉狭窄组根据3个亚区域进行分析：主动脉狭窄 - 保留区，周边保留组织；主动脉狭窄 - 纤维化区，钙化周围的纤维组织；主动脉狭窄 - 钙化区，钙化结节。

结果

肺炎衣原体抗原的中位数在正常组、动脉粥样硬化组、主动脉狭窄 - 保留区、主动脉狭窄 - 纤维化区和主动脉狭窄 - 钙化区分别为0.09、0.30、0.18、1.33和3.3。肺炎衣原体的量在动脉粥样硬化组和主动脉狭窄 - 钙化组中高于正常组（P<0.05）。肺炎衣原体在主动脉狭窄组的钙化和纤维化区域中比在保留区域中更多（P<0.05）。