Background Loss of myocytes is an important mechanism in the development of cardiac failure of either ischemic or nonischemic origin. However, whether programmed cell death (apoptosis) is implicated in the terminal stages of heart failure is not known. We therefore studied the magnitude of myocyte apoptosis in patients with intractable congestive heart failure. Methods Myocardial samples were obtained from the hearts of 36 patients who underwent cardiac transplantation and from the hearts of 3 patients who died soon after myocardial infarction. Samples from 11 normal hearts were used as controls. Apoptosis was evaluated histochemically, biochemically, and by a combination of histochemical analysis and confocal microscopy. The expression of two proto-oncogenes that influence apoptosis, BCL2 and BAX, was also determined. Results Heart failure was characterized morphologically by a 232-fold increase in myocyte apoptosis and biochemically by DNA laddering (an indicator of apoptosis). The histochemical demonst...

Apoptosis in the Failing Human Heart

http://unmhospitalist.pbworks.com/f/ACC+Preoperative+risk+2008.pdf

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)

http://www.area-c54.it/public/accaha%202007%20guidelines%20on%20perioperative%20cardiovascular%20evaluation%20and%20care%20for%20noncardiac%20surgery.pdf

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery)

Background The scarring of the heart that results from myocardial infarction has been interpreted as evidence that the heart is composed of myocytes that are unable to divide. However, recent observations have provided evidence of proliferation of myocytes in the adult heart. Therefore, we studied the extent of mitosis among myocytes after myocardial infarction in humans. Methods Samples from the border of the infarct and from areas of the myocardium distant from the infarct were obtained from 13 patients who had died 4 to 12 days after infarction. Ten normal hearts were used as controls. Myocytes that had entered the cell cycle in preparation for cell division were measured by labeling of the nuclear antigen Ki-67, which is associated with cell division. The fraction of myocyte nuclei that were undergoing mitosis was determined, and the mitotic index (the ratio of the number of nuclei undergoing mitosis to the number not undergoing mitosis) was calculated. The presence of mitotic spindles, contractile ri...

https://www.nejm.org/doi/pdf/10.1056/NEJM200110113451516

Evidence That Human Cardiac Myocytes Divide after Myocardial Infarction

State-of-the-Art PaperCardiorenal Syndrome

https://www.internationaljournalofcardiology.com/article/S0167-5273(15)00495-7/pdf

Ventricular aneurysms in cardiac sarcoidosis: From physiopathology to surgical treatment through a clinical case presenting with ventricular arrhythmias

Pathologic correlates of late gadolinium enhancement cardiovascular magnetic resonance in a heart transplant patient

Cardiac metastatic melanoma: Imaging diagnostic clues

A 70-year-old woman was referred to cardiac evaluation because of the detection of dilation of the main pulmonary artery by chest computed tomography performed before the removal of a thoracic lipoma. The computed tomography scan with contrast also excluded arterial thromboembolism of the main and distal pulmonary branches.

The patient had a previous diagnosis of mild pulmonary stenosis with a right ventricle-pulmonary artery peak systolic pressure gradient of 24 mm Hg by right catheterization in 1978. Since then, the patient has been asymptomatic, and she has been conducting normal daily-life activities without undergoing further cardiovascular controls. In 2001, a previous computed tomography scan had already shown mild dilatation of the main pulmonary artery for which no investigation was later performed.

On the first evaluation, the patient was asymptomatic, her heart rate was 83 bpm, and her blood pressure was 130/70 mm Hg. Cardiac examination revealed a regular rhythm, with a 3/6 systolic murmur at the upper right and left sternal border. Lung fields were normal; neither jugular venous distention nor hepatomegaly and peripheral edema were detected. The ECG showed sinus rhythm and normal atriventricular and intraventricular conduction, with slight ST-segment abnormalities in inferior leads.

Transthoracic echocardiography (Figure 1 and Movie I in the online-only Data Supplement) confirmed the presence of significant dilation of the main pulmonary …

An inverted location of the bicuspid valve disease: a variant of a variant.

/pdf/cardiac-magnetic-resonance-imaging-of-left-ventricular-zdn8kfwlyg.pdf

Alberto Roghi

Papers

Ventricular aneurysms in cardiac sarcoidosis: From physiopathology to surgical treatment through a clinical case presenting with ventricular arrhythmias

Pathologic correlates of late gadolinium enhancement cardiovascular magnetic resonance in a heart transplant patient

Cardiac metastatic melanoma: Imaging diagnostic clues

An inverted location of the bicuspid valve disease: a variant of a variant.

Cardiac magnetic resonance imaging of left ventricular apical hypoplasia in two complex congenital clinical syndromes