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Inflammation and fibrosis characterize different stages of myocardial remodeling in patients after stereotactic body radiotherapy of ventricular myocardium for recurrent ventricular tachycardia

T. Kučera, K. Jedličková, M. Šramko, P. Peichl, J. Cvek, L. Knybel, P. Hurník, R. Neuwirth, O. Jiravský, L. Voska, J. Kautzner

. 2023 ; 62 (-) : 107488. [pub] 20221004

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22032066

We performed a histological and immunohistochemical analysis of myocardia from 3 patients who underwent radiosurgery and died for various reasons 3 months to 9 months after radiotherapy. In Case 1 (death 3 months after radiotherapy) we observed a sharp transition between relatively intact and irradiated regions. In the myolytic foci, only scattered cardiomyocytes were left and the area was infiltrated by immune cells. Using immunohistochemistry we detected numerous inflammatory cells including CD68+/CD11c+ macrophages, CD4+ and CD8+ T-lymphocytes and some scattered CD20+ B-lymphocytes. Mast cells were diminished in contrast to viable myocardium. In Case 2 and Case 3 (death 6 and 9 months after radiotherapy, respectively) we found mostly fibrosis, infiltration by adipose tissue and foci of calcification. Inflammatory infiltrates were less pronounced. Our observations are in accordance with animal experimental studies and confirm a progress from myolysis to fibrosis. In addition, we demonstrate a role of pro-inflammatory macrophages in the earlier stages of myocardial remodeling after stereotactic radioablation for ventricular tachycardia.

Citace poskytuje Crossref.org

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$a Kučera, Tomáš $u Institute of Histology and Embryology, First Faculty of Medicine, Charles University, Albertov 4, 120 00, Prague, Czech Republic. Electronic address: tkucer@lf1.cuni.cz
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$a We performed a histological and immunohistochemical analysis of myocardia from 3 patients who underwent radiosurgery and died for various reasons 3 months to 9 months after radiotherapy. In Case 1 (death 3 months after radiotherapy) we observed a sharp transition between relatively intact and irradiated regions. In the myolytic foci, only scattered cardiomyocytes were left and the area was infiltrated by immune cells. Using immunohistochemistry we detected numerous inflammatory cells including CD68+/CD11c+ macrophages, CD4+ and CD8+ T-lymphocytes and some scattered CD20+ B-lymphocytes. Mast cells were diminished in contrast to viable myocardium. In Case 2 and Case 3 (death 6 and 9 months after radiotherapy, respectively) we found mostly fibrosis, infiltration by adipose tissue and foci of calcification. Inflammatory infiltrates were less pronounced. Our observations are in accordance with animal experimental studies and confirm a progress from myolysis to fibrosis. In addition, we demonstrate a role of pro-inflammatory macrophages in the earlier stages of myocardial remodeling after stereotactic radioablation for ventricular tachycardia.
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$a Jedličková, Kristína $u Department of Pathology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21, Prague, Czech Republic
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$a Šramko, Marek $u Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21, Prague, Czech Republic
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$a Peichl, Petr $u Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21, Prague, Czech Republic
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$a Cvek, Jakub $u Department of Oncology, University Hospital Ostrava, 17. listopadu 1790, 708 52, Ostrava, Czech Republic
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$a Neuwirth, Radek $u Faculty of Medicine, Masaryk University, Brno, Kamenice 753/5, 625 00 Brno; Agel Hospital Třinec Podlesí a.s., Konská 453, 739 61 Třinec, Czech Republic
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$a Voska, Luděk $u Department of Pathology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21, Prague, Czech Republic
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