A Development of Nucleic Chromatin Measurements as a New Prognostic Marker for Severe Chronic Heart FailureReportar como inadecuado




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Background

Accurate prediction of both mortality and morbidity is of significant importance, but it is challenging in patients with severe heart failure. It is especially difficult to detect the optimal time for implanting mechanical circulatory support devices in such patients. We aimed to analyze the morphometric ultrastructure of nuclear chromatin in cardiomyocytes by developing an original clinical histopathological method. Using this method, we developed a biomarker to predict poor outcome in patients with dilated cardiomyopathy DCM.

Methods and Results

As a part of their diagnostic evaluation, 171 patients underwent endomyocardial biopsy EMB. Of these, 63 patients diagnosed with DCM were included in this study. We used electron microscopic imaging of cardiomyocyte nuclei and an automated image analysis software program to assess whether it was possible to detect discontinuity of the nuclear periphery. Twelve months after EMB, all patients with a discontinuous nuclear periphery Group A, n = 11 died from heart failure or underwent left ventricular assist device VAD implantation. In contrast, in patients with a continuous nuclear periphery Group N, n = 52 only 7 patients 13% underwent VAD implantation and there were no deaths p<0.01. We then evaluated chromatin particle density Nuc-CS and chromatin thickness in the nuclear periphery Per-CS in Group N patients; these new parameters were able to identify patients with poor prognosis.

Conclusions

We developed novel morphometric methods based on cardiomyocyte nuclear chromatin that may provide pivotal information for early prediction of poor prognosis in patients with DCM.



Autor: Machiko Kanzaki, Yoshihiro Asano , Hatsue Ishibashi-Ueda, Eiji Oiki, Tomoki Nishida, Hiroshi Asanuma, Hisakazu Kato, Toru Oka, To

Fuente: http://plos.srce.hr/



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