Ventricular myocarditis coincides with atrial myocarditis in patients

Mark P. V. Begieneman, Reindert W. Emmens, Liza Rijvers, Bela Kubat, Walter J. Paulus, Alexander B. A. Vonk, Lawrence Rozendaal, P. Stefan Biesbroek, Diana Wouters, Sacha Zeerleder, Marieke van Ham, Stephane Heymans, Albert C. van Rossum, Hans W. M. Niessen, Paul A. J. Krijnen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

INTRODUCTION: Atrial fibrillation (AF) is a common complication in myocarditis. Atrial inflammation has been suggested to play an important role in the pathophysiology of AF. However, little is known about the occurrence of atrial inflammation in myocarditis patients. Here, we analyzed inflammatory cell numbers in the atria of myocarditis patients without symptomatic AF.

METHODS: Cardiac tissue was obtained postmortem from lymphocytic myocarditis patients (n=6), catecholamine-induced myocarditis patients (n=5), and control patients without pathological evidence of heart disease (n=5). Tissue sections of left and right ventricle and left and right atrium were stained for myeloperoxidase (neutrophilic granulocytes), CD45 (lymphocytes), and CD68 (macrophages). These cells were subsequently quantified in atrial and ventricular myocardium and atrial adipose tissue.

RESULTS: In lymphocytic myocarditis patients, a significant increase was observed for lymphocytes in the left atrial adipose tissue. In catecholamine-induced myocarditis patients, significant increases were found in the atria for all three inflammatory cell types. Infiltrating inflammatory cell numbers in the atrial myocardium correlated positively with those in the ventricles, especially in catecholamine-induced myocarditis patients.

CONCLUSIONS: To a varying extent, atrial myocarditis occurs concurrently with ventricular myocarditis in patients diagnosed with myocarditis of different etiology. This provides a substrate that potentially predisposes myocarditis patients to the development of AF and subsequent complications such as sudden cardiac death and heart failure.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalCardiovascular Pathology
Volume25
Issue number2
DOIs
Publication statusPublished - 15 Jan 2016

Cite this

Begieneman, Mark P. V. ; Emmens, Reindert W. ; Rijvers, Liza ; Kubat, Bela ; Paulus, Walter J. ; Vonk, Alexander B. A. ; Rozendaal, Lawrence ; Biesbroek, P. Stefan ; Wouters, Diana ; Zeerleder, Sacha ; van Ham, Marieke ; Heymans, Stephane ; van Rossum, Albert C. ; Niessen, Hans W. M. ; Krijnen, Paul A. J. / Ventricular myocarditis coincides with atrial myocarditis in patients. In: Cardiovascular Pathology. 2016 ; Vol. 25, No. 2. pp. 141-148.
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title = "Ventricular myocarditis coincides with atrial myocarditis in patients",
abstract = "INTRODUCTION: Atrial fibrillation (AF) is a common complication in myocarditis. Atrial inflammation has been suggested to play an important role in the pathophysiology of AF. However, little is known about the occurrence of atrial inflammation in myocarditis patients. Here, we analyzed inflammatory cell numbers in the atria of myocarditis patients without symptomatic AF.METHODS: Cardiac tissue was obtained postmortem from lymphocytic myocarditis patients (n=6), catecholamine-induced myocarditis patients (n=5), and control patients without pathological evidence of heart disease (n=5). Tissue sections of left and right ventricle and left and right atrium were stained for myeloperoxidase (neutrophilic granulocytes), CD45 (lymphocytes), and CD68 (macrophages). These cells were subsequently quantified in atrial and ventricular myocardium and atrial adipose tissue.RESULTS: In lymphocytic myocarditis patients, a significant increase was observed for lymphocytes in the left atrial adipose tissue. In catecholamine-induced myocarditis patients, significant increases were found in the atria for all three inflammatory cell types. Infiltrating inflammatory cell numbers in the atrial myocardium correlated positively with those in the ventricles, especially in catecholamine-induced myocarditis patients.CONCLUSIONS: To a varying extent, atrial myocarditis occurs concurrently with ventricular myocarditis in patients diagnosed with myocarditis of different etiology. This provides a substrate that potentially predisposes myocarditis patients to the development of AF and subsequent complications such as sudden cardiac death and heart failure.",
keywords = "Adult, Atrial Fibrillation, Female, Heart Atria, Heart Ventricles, Humans, Immunohistochemistry, Inflammation, Male, Myocarditis, Journal Article, Research Support, Non-U.S. Gov't",
author = "Begieneman, {Mark P. V.} and Emmens, {Reindert W.} and Liza Rijvers and Bela Kubat and Paulus, {Walter J.} and Vonk, {Alexander B. A.} and Lawrence Rozendaal and Biesbroek, {P. Stefan} and Diana Wouters and Sacha Zeerleder and {van Ham}, Marieke and Stephane Heymans and {van Rossum}, {Albert C.} and Niessen, {Hans W. M.} and Krijnen, {Paul A. J.}",
note = "Copyright {\circledC} 2015 Elsevier Inc. All rights reserved.",
year = "2016",
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doi = "10.1016/j.carpath.2015.12.001",
language = "English",
volume = "25",
pages = "141--148",
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Begieneman, MPV, Emmens, RW, Rijvers, L, Kubat, B, Paulus, WJ, Vonk, ABA, Rozendaal, L, Biesbroek, PS, Wouters, D, Zeerleder, S, van Ham, M, Heymans, S, van Rossum, AC, Niessen, HWM & Krijnen, PAJ 2016, 'Ventricular myocarditis coincides with atrial myocarditis in patients' Cardiovascular Pathology, vol. 25, no. 2, pp. 141-148. https://doi.org/10.1016/j.carpath.2015.12.001

Ventricular myocarditis coincides with atrial myocarditis in patients. / Begieneman, Mark P. V.; Emmens, Reindert W.; Rijvers, Liza; Kubat, Bela; Paulus, Walter J.; Vonk, Alexander B. A.; Rozendaal, Lawrence; Biesbroek, P. Stefan; Wouters, Diana; Zeerleder, Sacha; van Ham, Marieke; Heymans, Stephane; van Rossum, Albert C.; Niessen, Hans W. M.; Krijnen, Paul A. J.

In: Cardiovascular Pathology, Vol. 25, No. 2, 15.01.2016, p. 141-148.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Ventricular myocarditis coincides with atrial myocarditis in patients

AU - Begieneman, Mark P. V.

AU - Emmens, Reindert W.

AU - Rijvers, Liza

AU - Kubat, Bela

AU - Paulus, Walter J.

AU - Vonk, Alexander B. A.

AU - Rozendaal, Lawrence

AU - Biesbroek, P. Stefan

AU - Wouters, Diana

AU - Zeerleder, Sacha

AU - van Ham, Marieke

AU - Heymans, Stephane

AU - van Rossum, Albert C.

AU - Niessen, Hans W. M.

AU - Krijnen, Paul A. J.

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2016/1/15

Y1 - 2016/1/15

N2 - INTRODUCTION: Atrial fibrillation (AF) is a common complication in myocarditis. Atrial inflammation has been suggested to play an important role in the pathophysiology of AF. However, little is known about the occurrence of atrial inflammation in myocarditis patients. Here, we analyzed inflammatory cell numbers in the atria of myocarditis patients without symptomatic AF.METHODS: Cardiac tissue was obtained postmortem from lymphocytic myocarditis patients (n=6), catecholamine-induced myocarditis patients (n=5), and control patients without pathological evidence of heart disease (n=5). Tissue sections of left and right ventricle and left and right atrium were stained for myeloperoxidase (neutrophilic granulocytes), CD45 (lymphocytes), and CD68 (macrophages). These cells were subsequently quantified in atrial and ventricular myocardium and atrial adipose tissue.RESULTS: In lymphocytic myocarditis patients, a significant increase was observed for lymphocytes in the left atrial adipose tissue. In catecholamine-induced myocarditis patients, significant increases were found in the atria for all three inflammatory cell types. Infiltrating inflammatory cell numbers in the atrial myocardium correlated positively with those in the ventricles, especially in catecholamine-induced myocarditis patients.CONCLUSIONS: To a varying extent, atrial myocarditis occurs concurrently with ventricular myocarditis in patients diagnosed with myocarditis of different etiology. This provides a substrate that potentially predisposes myocarditis patients to the development of AF and subsequent complications such as sudden cardiac death and heart failure.

AB - INTRODUCTION: Atrial fibrillation (AF) is a common complication in myocarditis. Atrial inflammation has been suggested to play an important role in the pathophysiology of AF. However, little is known about the occurrence of atrial inflammation in myocarditis patients. Here, we analyzed inflammatory cell numbers in the atria of myocarditis patients without symptomatic AF.METHODS: Cardiac tissue was obtained postmortem from lymphocytic myocarditis patients (n=6), catecholamine-induced myocarditis patients (n=5), and control patients without pathological evidence of heart disease (n=5). Tissue sections of left and right ventricle and left and right atrium were stained for myeloperoxidase (neutrophilic granulocytes), CD45 (lymphocytes), and CD68 (macrophages). These cells were subsequently quantified in atrial and ventricular myocardium and atrial adipose tissue.RESULTS: In lymphocytic myocarditis patients, a significant increase was observed for lymphocytes in the left atrial adipose tissue. In catecholamine-induced myocarditis patients, significant increases were found in the atria for all three inflammatory cell types. Infiltrating inflammatory cell numbers in the atrial myocardium correlated positively with those in the ventricles, especially in catecholamine-induced myocarditis patients.CONCLUSIONS: To a varying extent, atrial myocarditis occurs concurrently with ventricular myocarditis in patients diagnosed with myocarditis of different etiology. This provides a substrate that potentially predisposes myocarditis patients to the development of AF and subsequent complications such as sudden cardiac death and heart failure.

KW - Adult

KW - Atrial Fibrillation

KW - Female

KW - Heart Atria

KW - Heart Ventricles

KW - Humans

KW - Immunohistochemistry

KW - Inflammation

KW - Male

KW - Myocarditis

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.carpath.2015.12.001

DO - 10.1016/j.carpath.2015.12.001

M3 - Article

VL - 25

SP - 141

EP - 148

JO - Cardiovascular Pathology

JF - Cardiovascular Pathology

SN - 1054-8807

IS - 2

ER -