Harasaki H, Hanano H, Tanaka J, Tokunaga K, Torisu M
J Cardiovasc Surg (Torino). 1978 May-Jun;19(3):281-90.
This article reports the surface structure of the endothelial cells covering the cardiac valves and their changes in chronic inactive rheumatic valvulitis and bacterial endocarditis. The endocardial surface of the normal cardiac valve was covered by a layer of endothelial cells, each of which was recognized because of the presence of centrally located nuclear bulge and marginal folds at the cell boundaries. In the cardiac valves affected by chronic rheumatic valvulitis, the endothelial layer denuded extensively, even in the regions where only slight thickening was noticed in the intravalvular tissues. As compared to the inflow side of the valve, denudation of the endothelial layer was more conspicuous on the outflow side. There was no morphological difference between the two hemodynamically different conditions, i.e. stenosis and regurgitation. In the cardiac valves affected by bacterial endocarditis, in contrast, the destruction of the endothelial layer was preferentially observed along the closing margins of the valve, and in the region of calcification and vegetation. These findings are compatible to the interpretation that differences in morphological changes of the endothelial layer in these two acquired valvular diseases may reflect the differences of their pathogeneses. The present study thus suggest an importance of endothelial cell in elucidating the pathogenesis of acquired valvular diseases.
本文报道了覆盖心脏瓣膜的内皮细胞的表面结构及其在慢性非活动性风湿性瓣膜炎和细菌性心内膜炎中的变化。正常心脏瓣膜的心内膜表面覆盖着一层内皮细胞，每个内皮细胞都因其细胞边界处有位于中央的核凸起和边缘褶皱而被识别。在患有慢性风湿性瓣膜炎的心脏瓣膜中，即使在瓣膜内组织仅出现轻微增厚的区域，内皮层也广泛剥脱。与瓣膜的流入侧相比，内皮层的剥脱在流出侧更为明显。在两种血流动力学不同的情况，即狭窄和反流之间，没有形态学差异。相比之下，在患有细菌性心内膜炎的心脏瓣膜中，内皮细胞层的破坏主要沿瓣膜的闭合边缘以及钙化和赘生物区域观察到。这些发现与以下解释相符，即这两种后天性瓣膜疾病中内皮细胞层形态变化的差异可能反映了它们发病机制的不同。因此，本研究表明内皮细胞在阐明后天性瓣膜疾病发病机制中的重要性。
