Amyloid-containing renal interstitial cell nodules (RICNs) associated with chronic arterial hypertension in older age groups.

A highly significant correlation is demonstrated between the presence in older persons of medullary renal interstitial cell nodules (RICNs) containing amyloid and increased heart weight indicative of chronic arterial hypertension. By contrast, the population with amyloid-free RICNs 1) showed heart weights comparable to those of controls and 2) had a mean age about 11 years less (56.7 +/- 9.6 vs 68 +/- 12 years) than the group with amyloid-containing RICNs. In a series of 55 autopsy cases presenting with RICNs, no individual was younger than 30 years. In two cases, in which fresh material was available, histochemical reactions suggested that the RICNs contained APUD amyloid. It is speculated that fully functional RICNs may evolve on a compensatory base counteracting an increase in mean arterial blood pressure and that the deposition of amyloid within RICNs could be associated with, or be an expression of, a reduced endocrine function of these structures, finally resulting in the development of arterial hypertension.     

'Derivation of new reference tables for human heart weights in light of increasing body mass index'

As body weights and body mass indices have increased over time, we questioned the validity of correlating heart weight with body weight and whether tables from previous decades remain relevant. We investigated this by collecting details of heart weight, body weight, height, gender and age from 384 autopsy cases with no obvious heart or lung disease. Heart weights, body weights and heights showed a normal distribution for both genders. Heart weight correlated slightly better with body surface area than body weight and we present new reference charts derived from these data. The correlation between heart weight and body weight has changed little, despite increases in body weight and body mass index. As life expectancy is increasing, we investigated the effect of age on heart weight and demonstrated a small increase in heart weight relative to body surface area for both genders, in contrast to a previous study.     

An Integrative Model of the Cardiovascular System Coupling Heart Cellular Mechanics with Arterial Network Hemodynamics

The current study proposes a model of the cardiovascular system that couples heart cell mechanics with arterial hemodynamics to examine the physiological role of arterial blood pressure (BP) in left ventricular hypertrophy (LVH). We developed a comprehensive multiphysics and multiscale cardiovascular model of the cardiovascular system that simulates physiological events, from membrane excitation and the contraction of a cardiac cell to heart mechanics and arterial blood hemodynamics. Using this model, we delineated the relationship between arterial BP or pulse wave velocity and LVH. Computed results were compared with existing clinical and experimental observations. To investigate the relationship between arterial hemodynamics and LVH, we performed a parametric study based on arterial wall stiffness, which was obtained in the model. Peak cellular stress of the left ventricle and systolic blood pressure (SBP) in the brachial and central arteries also increased; however, further increases were limited for higher arterial stiffness values. Interestingly, when we doubled the value of arterial stiffness from the baseline value, the percentage increase of SBP in the central artery was about 6.7% whereas that of the brachial artery was about 3.4%. It is suggested that SBP in the central artery is more critical for predicting LVH as compared with other blood pressure measurements.     

Organ weights in healthy and apparently healthy Danish infants

The weights of brain, heart, liver, kidneys, spleen, lungs, and thymus were registered in 222 forensic autopsies of Danish infants aged 1 week to 0.99 year (137 males, 85 females), who prior to death were healthy or apparently healthy based on clinical evidence. Variability of organ weights was estimated, and the relationship between individual organ weights and age, body weight, and body length, and the sum of organ weights was evaluated in relation to age, body weight, and body length. No significant differences were found between males and females, and between the healthy and apparently healthy infants. There was a positive, significant correlation of the individual organ weights with age, body weight, and body length. It was most pronounced for the weight of the brain and least pronounced for the thymus. Am. J. Hum. Biol. 9:35–38 © 1997 Wiley-Liss, Inc.     

Acquired coronary arterial aneurysms: an autopsy study of 52 patients

In the past decade most studies of coronary arterial aneurysms have been clinical; few have focused on morphology and etiopathogenesis. The subjects of the present autopsy study were 52 patients, 5 months to 80 years of age, with coronary arterial aneurysms. Patients were divided into two groups: 38 with atherosclerotic coronary aneurysms and 14 with aneurysms secondary to inflammation. Of the 38 patients with atherosclerotic aneurysms, 20 (53 per cent) had histories of ischemic heart disease; the aneurysms were in the right coronary artery in 18 (47 per cent), the left coronary artery in 13 (35 per cent), and in the right and left coronary arteries in seven (18 per cent). Of the four major coronary arteries, the average number of severely narrowed arteries (reduction of more than 75 per cent) in cross-sectional luminal area) was 1.8/patient; aortic aneurysms were present in eight of these patients (24 per cent). Of the 14 patients with coronary aneurysms secondary to inflammation, four had histories of ischemic heart disease; 10 had histories of an influenza-like syndrome. Isolated left coronary arterial aneurysms were seen in six of these patients (43 per cent), while eight (51 per cent) had multiple right and left coronary arterial aneurysms. The average number of severely narrowed coronary arteries in this group was 1.5/patient, and only one patient had an aortic aneurysm. Therefore, patients with atherosclerotic aneurysms are more often symptomatic; they have increased heart weights and equal numbers of coronary arterial aneurysms in the right and left vessels, and the majority (89 per cent) have single aneurysms with thrombi in the lumen. Patients with coronary arterial aneurysms secondary to inflammation are younger; the majority of these patients have a prodromal influenza-like syndrome, a low incidence of ischemic heart disease, and multiple coronary arterial aneurysms.     

Ventricular morphology and pumping ability of exercised spontaneously hypertensive rats.

Spontaneously hypertensive rats (SHR) and two strains of normotensive Wistar rats were subjected to a 5 day/wk swimming program to determine whether the heart of the SHR could respond to an additional stimulus to cardiac growth. Swimming was tolerated well by all rats. Although body weight of the exercised groups was not significantly reduced, both the right and left ventricular weights of all exercised groups were increased. Left ventricular circumference and chamber volume were increased without a change in free wall thickness in all exercised groups. Ventricular performance was assessed by peak cardiac output and stroke volume attained during rapid intravenous volume loading, both before and after autonomic inhibition. After combined cholinergic and beta-adrenergic inhibition, all exercised rats had slower heart rates and higher peak stroke volume than respectively sedentary controls. Thus, exercised SHR had the same alterations in cardiac mass and performance as exercised normotensive rats. Despite the initial presence of left ventricular hypertrophy, the SHR responded appropriately to an additional stimulus for adaptive cardiac growth.     

Heterogeneity of Left Ventricular Cardiomyocytes from Rat Heart

Contractile cardiomyocytes in various parts of the heart differ in shape, size, ploidy, and other parameters. However, it is not known whether their population is heterogeneous within each heart chamber. In this paper, dry weight and ploidy of cardiomyocytes were estimated in different parts of rat left ventricle. It was found that the dry weight of cardiomyocytes in medial part of left ventricular anterior wall is higher than in other parts of the ventricle. Cardiomyocyte ploidy is the same in different regions of the left ventricle.     

Comparative stereometric investigation of the intramural arterial bed of the human myocardium by injection and noninjection methods

A comparative stereometric investigation was made of the intramural arterial bed of the wall of the left ventricle in 20 injected and 30 noninjected hearts from clinically healthy persons aged 24–87 years dying as a result of trauma. The volume density of the intramural arterial bed of the myocardium (V_v) of the wall of the left ventricle was found to be on average 9 times greater in the injected than in the noninjected hearts. The value of V_v was highest with an average type of coronary blood supply. A nonlinear relationship was found between V_v and age. With an increase in the weight of the heart, V_v fell. In hearts of equal weight from women and men, V_v was significantly higher in women. The noninjection stereometric method of investigation of the intramural arterial bed of the heart simplifies the evaluation of the state of the myocardial blood supply, makes it more objective, and can be used in morbid anatomical practice.Central Morbid Anatomical Laboratory, Institute of Human Morphology, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR A. P. Avtsyn.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 85, No. 1, pp. 84–87, January, 1978.     

The effect of chronic hyperinsulinemia on ovine fetal growth

Infusion of exogenous insulin for 18 days to seven ovine twin fetuses caused hyperinsulinemia (31.0 +/- 6.9 microU/ml) when each was compared to its sham-infused twin (6.6 +/- 0.7 microU/ml). The hyperinsulinemic fetuses also had lower arterial serum glucose concentrations (0.77 +/- 0.07 mM) than their sham-infused controls (1.10 +/- 0.04 mM). There were no significant changes in fetal weight or height attributable to insulin infusion. Our methods would have detected a 12% difference in fetal weight; therefore, the lack of effect of insulin on fetal weights was not due to excessive variability of the difference in weights between twins. Hyperinsulinemia increased the myocardial cellular contents of protein and RNA, which suggested that myocardial hypertrophy occurred; however, heart weight itself was not significantly increased. This apparent contradiction may be due to considerable variability in heart weight. From the above data, we conclude that 19 days of documented ovine fetal hyperinsulinemia does not increase the growth rate of the nearterm ovine fetus.     

A biocompatible flow chamber to study the hemodynamic performance of prosthetic heart valves

The goal of this study was to design, fabricate, and characterize a biocompatible flow chamber to study the performance of artificial heart valves. The system consists of a testing fluid chamber and a water chamber (separated by a latex diaphragm), following the design of a left ventricular assist device. Two St. Jude bileaflet mechanical heart valves were placed oppositely in the testing fluid chamber to control flow direction. The flow rate of the testing fluid chamber was set at 5.6 L/min, with a stroke volume of 80 ml. The performance of the system was examined through three-dimensional numerical simulation and in vitro experiments with whole blood and washed platelets. Hemolysis was measured with whole blood using a spectrophotometer. Platelet activation was measured by platelet surface P-selectin expression using flow cytometry. The three-dimensional computational fluid dynamics model demonstrated that the flow field in the chamber was laminar and physiological. Results from in vitro experiments indicated that the flow conditions in the chamber did not induce hemolysis or platelet activation with the presence of St. Jude heart valves. Overall, the flow chamber can provide a feasible environment to study the hemodynamic performance of artificial heart valves.     

Arterial compliance is a main variable determining the effectiveness of intra-aortic balloon counterpulsation: quantitative data from an in vitro study

Quantitative data concerning the effect of arterial compliance (AC) on the effectiveness of intra-aortic balloon counterpulsation (IABC) are lacking. The main objective of this study was to investigate the relationship between AC and IABC performance. For this purpose we constructed a Windkessel, lumped-element, hydraulic model of the systemic circulation. The model consisted of a left ventricular assist device (LVAD), a compliance chamber, a peripheral resistor and two open reservoirs. Two Datascope Driving systems were used to operate the LVAD and intra-aortic balloon. We studied the effect of arterial compliance on the effectiveness of IABC at different levels of mean pressure (55, 75 and 95 mmHg) and heart rates (80, 100, 120 bpm). Three indices were used to evaluate IABC performance: the reduction of systolic and end-diastolic "arterial" pressure and the augmentation of diastolic pressure, induced by the IABC. A 22% decrease in AC (1.8-1.4 ml/mmHg) lead to a 30-40% increase in the indices of IABC performance, independently from pressure. In conclusion, arterial compliance significantly affects IABC efficacy and it could be considered as a further clinical criterion to decide IABC application.     

Influence of a diet rich in fish oil on blood pressure,body weight and cardiac hypertrophy in spontaneously hypertensive rats

Summary The effects of a diet rich in fish oil on arterial blood pressure, body weight, left ventricular weight and heart rate have been investigated in 8 month old spontaneously hypertensive male rats (SHR) as compared to age-matched hypertensive controls. A diet containing 10% fish oil decreased blood pressure by about 40 mmHg within 20 days of starting the experiment, and this effect persisted over the observation period of 80 days. Permitting the animals free access to food, the body weight of the diet group increased by 25%. The degree of hypertrophy as evaluated by relating left ventricular weight to tibial length was significantly reduced (10%) in the diet fed group. Heart rate was increased by 53%. The study demonstrates that a diet rich in fish oil can lower arterial blood pressure over several weeks without a recognizable loss in function despite a considerable increase in body weight. It can be assumed that a more marked regression of left ventricular hypertrophy is counteracted by a reflex increase in sympathetic efferentation to the heart.     

The assessment of cardiac hypertrophy at autopsy

The total weight of the normal adult human heart as well as that of each ventricle is proportional to body size. Body weight is superior to height as a predictor of total heart and isolated ventricular weights. Ventricular wall thickness is an insensitive means of assessing ventricular hypertrophy. Heart weight is a poor predictor of isolated right ventricular mass but a slightly better predictor of isolated left ventricular mass. The only method of determining the presence or absence of hypertrophy with confidence is to use the Fulton technique for isolated ventricular weights. The use of an arbitrary upper and lower limit, as currently used, for isolated ventricular weights obtained by Fulton's method may, however lead to errors in determining the presence or absence of ventricular hypertrophy.     

Organ asymmetries as correlates of other anomalies

Fetuses with deviations in the normal left versus right weight relationships of the paired viscera were examined for correlation with particular malformations, syndromes, or other common factors. Alterations of the normal pattern were observed among cases with cytogenetic anomalies, diaphragmatic hernia, renal duplication, dyshydramnios, and single umbilical artery. A reversal of the left versus right weight pattern was found in the adrenals of cases with hepatic situs inversus but not in those with heterotaxic cardiac lesions. Recipient twins in the twin-twin transfusion syndrome had reduced left lung weights, presumably because of inhibition of lung growth by the enlarged heart. The side of umbilical artery absence did not predict either the nature or complexity of associated malformations. However, it is suggestive that there is discordance between the side of the missing artery and unilateral renal abnormality and that there is preferential absence of the right or left artery, depending on the karyotype.     

Nek6在心力衰竭家兔心脏中的表达增加

目的：通过刺破主动脉瓣造成反流加重心脏前负荷联合缩窄腹主动脉加重心脏后负荷制作心力衰竭模型,研究Nek6在心力衰竭家兔心脏的心肌细胞中含量表达的改变,初步探讨Nek6在心力衰竭发生发展中的作用。方法将日本大耳白兔分为心衰组和对照组各10只,通过刺破主动脉瓣及缩窄腹主动脉两次手术制作心衰组模型,对照组仅行假手术。2月后使用超声检测心脏各腔室大小及室壁厚度,并计算射血分数;处死家兔后,计算心脏重量与身体重量比值,使用HE染色分析比较心肌细胞面积,使用PSR染色分析比较基质胶原含量,使用Nek6免疫组化染色分析Nek6蛋白含量变化。结果与对照组相比,心衰组家兔左室收缩末期内径及舒张末期内径均增加,射血分数降低,身心比增加,细胞明显增大,胶原增多, Nek6蛋白含量增加。结论 Nek6在心力衰竭家兔心脏的心肌细胞中表达明显上升。     

The evaluation of organ weights by means of multiple regression equations (author's transl)]

The investigation is based on the weights of 570 livers, 648 spleens, 200 right and left lungs, 559 right and 556 left kidneys of 364 male and 360 female persons over 20 years of age being autopsied in our Institute from 1969 to 1972. In both sexes these weights were set in relation to age, body weight, body height, breast width, breast depth and circumference of chest. By the application of higher statistical methods and under computerusage it was made possible to state, that there is a marked relationship between the organ weight on one hand and the body weight and in women the body height on the other. The relationship between the organ weight and various constitutional sizes and age is less marked. In practice these relations should be considered. This can be done by multiple regression equations, which enables us to evaluate the weight of spleen, lungs, kidneys and female livers, but not the weight of the male liver. It must be considered, that the estimated weight of spleen and kidney of both sexes is more inaccurate than that of the lungs of both sexes and of the female livers. The multiple regression equations are tabulated for both sexes (table 4).     

Plasma brain natriuretic peptide correlates with infarct size but not with subsequent remodeling in the rat heart.

BACKGROUND: Brain natriuretic peptide is a marker of the severity of congestive heart failure. However, the relation between its concentration and ventricular remodeling after myocardial infarction remains unknown. Thus, we studied plasma brain natriuretic peptide over 6 months after myocardial infarction in the rat and correlated it with parameters of left ventricular remodeling. METHODS: Myocardial infarction was induced in 152 male Wistar rats by left coronary artery ligation. Rats were followed up for 1 week, 1 month, 3 months, or 6 months after myocardial infarction. Then left ventricular end-diastolic volume and maximal systolic pressure were assessed in the isolated heart, heart and lung weights were obtained, wall stress was calculated, cardiomyocyte size was measured, and plasma brain natriuretic peptide was assessed with enzyme-linked immunosorbent assay. RESULTS: Large (> or =40%) but not small/intermediate infarcts were accompanied by progressive ventricular dilation and increase in wall stress, left ventricular weight, and lung weight, while systolic pressure, which was already depressed 1 week after myocardial infarction, did not show progression over time. Plasma brain natriuretic peptide reached its peak on Day 3 after myocardial infarction and did not progress any further; it correlated with infarct size and the extent of left ventricular dilation. CONCLUSIONS: Thus, after a large myocardial infarction in the rat, despite progressive left ventricular dilation and increase in wall stress, plasma brain natriuretic peptide did not progress over time. This indicates that, although plasma brain natriuretic peptide is a good indicator of infarct size and left ventricular dilation, it cannot be used to trace progressive ventricular remodeling in the rat heart after myocardial infarction.     

Relationships between organ weight and body/brain weight in the rat: what is the best analytical endpoint?

Analysis of organ weight in toxicology studies is an important endpoint for identification of potentially harmful effects of chemicals. Differences in organ weight between treatment groups are often accompanied by differences in body weight between these groups, making interpretation of organ weight differences more difficult. Using data from control rats that were part of 26 toxicity studies conducted under similar conditions, we have evaluated the relationship between organ weight and body/brain weight to determine which endpoint (organ weight, organ-to-body weight ratio, or organ-to-brain weight ratio) is likely to accurately detect target organ toxicity. This evaluation has shown that analysis of organ-to-body weight ratios is predictive for evaluating liver and thyroid gland weights, and organ-to-brain weight ratios is predictive for evaluating ovary and adrenal gland weights. Brain, heart, kidney, pituitary gland, and testes weights are not modeled well by any of the choices, and alternative analysis methods such as analysis of covariance should be utilized.     

The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts

BACKGROUND: The purpose of the present study was to evaluate the extent of the ventricular epicardial fat and its relationship with the underlying myocardium, neither of which is still completely understood. METHODS: A total of 117 autoptic human hearts was subdivided into four groups: normals (N), ischemics (I), hypertrophics (H) and hypertrophic-ischemics (HI). In each heart, the ventricular myocardial and epicardial fat weights were measured. On the basis of these data, the epicardial fat percentage within the ventricles was calculated. RESULTS: The left, right and total ventricular fat weights were greater in H and HI than in N and I (P<.05, P<.05, P<.01, respectively). No differences were detected in the epicardial fat weights in comparing H versus HI and N versus I. Moreover, the fat percentage in each ventricle did not vary between the four groups. However, if compared with the right ventricle, the left ventricle showed an epicardial fat percentage consistently lower (P<.0001). In nonhypertrophied hearts (N and I), the body mass index and the total epicardial fat weight were correlated (P<.05), whereas in hypertrophied hearts (H and HI), they were not. CONCLUSIONS: A constant fat-muscle ratio exists in each ventricle, which is not influenced by ischemia or hypertrophy. Accordingly, during the hypertrophic process, the ventricular fat and the underlying myocardium show a parallel and correlated increase in their masses.     

Weights of the body and cardiac ventricles in pulmonary emphysema

Summary We analysed statistically the association of emphysema, determined on inflation fixed specimens, with the weights of the body and heart, and of the cardiac ventricles, weighed separately, in 170 male and 86 female adult autopsies. The cases were grouped according to the cause of death into cardiovascular, cancer and other deaths. In men the body weight was inversely proportional to the severity of emphysema, but no association existed between the body weight and the cause of death. In male cardiovascular deaths the total heart weight, total ventricular weight and the weight of the left ventricle with the septum were also inversely proportional to the severity of emphysema while this was not true in the other deaths. In male cardiovascular deaths a decrease, and in the other deaths an increase, of the weight of the free wall of the right ventricle was associated with an increasing severity of emphysema. In all male deaths, however, the left to right ratio decreased with an increasing severity of emphysema. Thus, pulmonary emphysema is associated both with a general atrophy, including the myocardium, and a mainly relative right ventricular hypertrophy. An absolute right ventricular hypertrophy, however, seems to accompany emphysema only in the absence of other major cardiovascular diseases.