Oki H, Inoue S, Makishima N, Takeyama Y, Shiokawa A
Second Department of Pathology, Showa University School of Medicine, Tokyo, Japan.
Jpn Circ J. 1994 Jun;58(6):389-94. doi: 10.1253/jcj.58.389.
Depletion of norepinephrine in the left ventricular myocardium in cases of dilated cardiomyopathy (DCM) has been suggested. However, there have been few histological studies of the sympathetic nerves, in which myocardial norepinephrine is believed to exist. We performed an immunohistological study of the density of tyrosine hydroxylase (TH, a marker of sympathetic nerves)-positive nerve fiber in endomyocardial biopsy specimens in cases of DCM using antibody against TH. TH-positive nerves were stained brown along with the myocardium, and they were more dense in the right ventricle than in the left ventricle in both the DCM and control groups. The density of TH-positive nerves in cases of DCM was significantly less than that in the control group in the subendocardial myocardium of the right and left ventricles, but especially in the left ventricle. A correlation was observed in the DCM group between the density of TH-positive nerves and the ejection fraction in the right ventricle, but not in the left ventricle. In the failing human heart, a decrease in subendocardial sympathetic nerve density may be one of the causes of myocardial norepinephrine depletion.
有人提出，扩张型心肌病（DCM）患者左心室心肌中的去甲肾上腺素会耗竭。然而，关于交感神经的组织学研究很少，而心肌中的去甲肾上腺素被认为存在于交感神经中。我们使用抗酪氨酸羟化酶（TH，交感神经标志物）抗体，对DCM患者心内膜活检标本中TH阳性神经纤维的密度进行了免疫组织学研究。TH阳性神经与心肌一起被染成棕色，在DCM组和对照组中，右心室的TH阳性神经比左心室更密集。在DCM患者中，左右心室心内膜下心肌中TH阳性神经的密度显著低于对照组，尤其是左心室。在DCM组中，观察到右心室TH阳性神经密度与射血分数之间存在相关性，而左心室则无此相关性。在衰竭的人类心脏中，心内膜下交感神经密度降低可能是心肌去甲肾上腺素耗竭的原因之一。
