[Histological biomorphosis of human heart valve. II. Morphometric studies]

Previous polarization-microscopical measurements combined with silver-staining methods at histological sections of the bicuspid valve and the tricuspid valve in the region of fibrosa showed (similar to that of the corresponding tendinous cords) for middle-aged persons a distinct difference in the collagen composition in comparison between high pressure vs. low pressure system. The aim of the current study was the morphometric investigation of the collagen composition, of the relative content of total collagen (measured as relative number of total collagen fibers per measuring area), and of the cell-collagen relation in dependence of age and possibly on sex in the high and low pressure system, respectively. Tissue samples of atrioventricular valves of 67 probands of both sexes were available. The probands were healthy with regard to heart and circulation and distributed in 3 age groups (1st to 2nd decade, 3rd to 5th decade, and 6th to 9th decade). After corresponding preliminary treatment, the histological sections of tissue samples were evaluated by a suitable combination of polarization-microscopical, immuno-histochemical, and morphometrical methodology. The thickness of the heart valves was measured by microscopic image analysis. A rise of the number of fibers per measuring area (ma) for both sexes and both valves was observed with increasing age. The slopes of the linear regression curves and the mean values of the numbers of collagenous fibers/ma (for each age group) were different between both sexes. They depend upon the valve considered. Analogous to these results, the differentiated statements were possible to the number of fibers/ma and to the percentages of the fiber species by the distinction between the collagen types I and III in the fibrosa of the heart valves. Whereas the relative numbers of fibers/ma rose with increasing age, the number of cell (fibroblasts, fibrocytes) nuclei for both valves and sexes slightly decreased. For the latter, there was no difference between high and low pressure system in contrast to the collagenous fibers. The opposite age-dependent behavior of the collagenous fibers and of their producing cells during the biomorphosis of the heart valves could be explained with the collagen turn-over.