CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 3, 1998, No 2

Infundibular Septal Cellular and Subcellular Changes in Neuroendocrine Elements in Tetralogy of Fallot

L. B. McGrath, W. Boris, J. Gu

Abstract:
Background: Previous reports have described morphologic changes in infundibular myocytes in tetralogy of Fallot patients, with important differences noted in the neuronal and amine receptor content of the infundibular septal muscle. However, analysis of cardiac hormones and nerves has not been reported. In this study the distribution of hormonal and neuronal elements in the infundibular muscle of 19 consecutive tetralogy of Fallot patients undergoing repair was examined with immunohistochemistry and was correlated to pathologic findings to determine if morphologic changes are possibly related to pathophysiology in this congenital heart defect. Methods: Atrial natriuretic peptide (ANP), neuron specific enolase (NSE), protein gene product 9.5 (PGP 9.5), S-100, neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), substance P, Somatostatin and tyrosine hydroxylase (TH) distributions were analyzed by immunocytochemistry. The results were compared with those obtained from age matched subjects without heart diseases. Results: ANP, NSE, and S-100 immunoreactivities were observed in the hypertrophic infundibular myocytes. The intensity of the stainings correlated to the degree of hypertrophy. Local cardiac innervation was disrupted, with marked attenuation of NPY and TH containing nerves in the atrophic and degenerative areas. Conclusion: These hypertrophic and degenerative changes in neuroendocrine elements indicate possible immaturity and/or de-differentiation of myocytes into a fetal or neonatal state. The changes in neuronal and endocrinal elements may be associated with early and late phase events following otherwise apparently successful surgical repair.

Keywords:
tetralogy of Fallot, peptide, nerves, endocrine, immunohistochemistry

Address for Correspondence:

Reference:
(CVE. 1998; 3 (2): 71-78)

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