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Quantitative changes in mast cell populations after left ventricular assist device implantation
Ahmet Akgul1, Keith A Youker, George P Noon
1Yuksek Ihtisas Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|June 23, 2005
Summary
Mechanical support with left ventricular assist devices (LVADs) increases cardiac mast cells but decreases myocardial fibrosis in heart failure patients. This suggests mast cells play a dual role in fibrosis progression and improvement.
Area of Science:
- Cardiology
- Pathology
- Biomedical Engineering
Background:
- Mast cells are implicated in tissue remodeling and fibrosis.
- End-stage cardiomyopathy involves myocardial fibrosis and altered mast cell presence.
Purpose of the Study:
- To investigate the impact of mechanical ventricular unloading via LVAD on myocardial fibrosis and mast cell density.
- To compare mast cell density and fibrosis in cardiomyopathy, LVAD-supported hearts, and donor hearts.
Main Methods:
- Analysis of paired myocardial tissue samples from 30 patients before and after LVAD implantation.
- Comparison with donor heart tissue.
- Quantification of mast cells (tryptase-positive) and interstitial collagen via tissue staining.
Main Results:
- Mast cell density was higher in cardiomyopathy patients than in donor hearts (p=0.04) and increased after LVAD support (p=0.01).
- Mast cells were localized in areas of interstitial fibrosis.
- A significant correlation between mast cells and collagen existed before LVAD implantation (p=0.03) but not after (p=0.18).
Conclusions:
- LVAD support increases myocardial mast cell number and reduces myocardial fibrosis.
- Cardiac mast cells exhibit a dual role in heart failure fibrosis: contributing to its increase and then decreasing it following LVAD intervention and cardiac improvement.