- 作者：Arnt V. Kristen ; Philipp A. Schnabel ; Bettina Winter ; Burkhard M. Helmke ; Thomas Longerich ; Stefan Hardt ; Achim Koch ; Falk-Udo Sack ; Hugo A. Katus ; Reinhold P. Linke ; Thomas J. Dengler
- 关键词：Amyloid ; Atherosclerosis ; Heart valves ; Hyperlipidemia ; Immunohistochemistry ; Apolipoprotein AI
- 刊名：Cardiovascular Pathology
- 出版年：2010
- 出版时间：July-August 2010
- 年：2010
- 卷：19
- 期：4
- 页码：228-235
- 全文大小：721 K
IntroductionThe prevalence, pathophysiology, and clinical indicators of valvular amyloid deposition have not been clarified yet.Methods
One hundred fifty surgically resected heart valve specimens [67.4±1.0 years; aortic stenosis (AS), n=100; aortic regurgitation, n=19; mitral stenosis, n=7; mitral regurgitation, n=24] were qualitatively, semiquantitatively, and immunohistochemically analyzed and correlated with clinical data.
Results
Amyloid was found in 83/150 specimens with highest prevalence in AS (74/100), intermediate prevalence in mitral stenosis (2/7) and regurgitation (7/24), and lowest prevalence in aortic regurgitation (2/19). Severe and polymorphic amyloid deposits were almost exclusively found in AS (35/100). Filamentous cloudy amyloid patterns occurred with the same frequency in AS (29/100). A combination of both was found only in AS (n=7/100). By immunohistochemistry, none of the most common amyloid proteins was identified except for a weak staining by the apolipoprotein AI antibody, but more intense adjacent to amyloid deposits. Amyloid correlated with valvular thickening (P<.05), hyperlipidemia (P=.07), coronary artery disease (P=.084), and obesity (P=.082).
Conclusions
Localized valvular amyloid is predominantly found in stenotic aortic valves. It appears to depend on atheroinflammatory conditions and high shear-stress hemodynamics. Further studies are needed to identify the underlying protein.