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[Pathology of the heart and blood vessels in Hansen's disease]
1Division of Research and Examination, National Leprosarium Tama-Zenshouen, Tokyo.
Insights
Cardiovascular changes in Hansen's disease (leprosy) include cardiac fibrosis, particularly in T-type cases. These changes may be linked to nerve damage and circulatory issues, potentially promoting ischemic heart disease.
Area of Science:
- Cardiovascular pathology
- Neuropathology
- Leprosy research
Context:
- Limited understanding of cardiovascular alterations in Hansen's disease (leprosy).
- Previous studies have not fully elucidated the cardiac and vascular changes associated with different leprosy types.
Purpose:
- To investigate macroscopic and histologic cardiovascular changes in autopsy and biopsy cases of Hansen's disease.
- To examine small blood vessels and capillaries using electron microscopy.
- To correlate observed changes with leprosy types (L, B, T).
Summary:
- Autopsy and biopsy examinations revealed cardiac atrophy, hypertrophy, fibrosis, endocarditis, epicarditis, and coronary sclerosis.
- Severe cardiac fibrosis was significantly more prevalent in T-type leprosy cases.
- Peripheral nerves around epicardial arteries and myocardial arterioles showed atrophy, fibrosis, swelling, and hyperplasia, linked to vascular aging and leprosy-related circulatory disturbances.
Impact:
- Findings suggest that paralytic arterial changes, potentially involving vasomotor nerves, may contribute to ischemic cardiac disease or fibrosis in leprosy patients.
- Highlights the complex interplay between leprosy, vascular health, and cardiac outcomes.
- Provides a basis for further research into targeted cardiovascular interventions for leprosy patients.
Abstract:
There are few reports on the cardiovascular changes accompanying Hansen's disease, and many aspects remain unclear. We performed macroscopic and histologic examinations on the cardiovascular system in autopsy (47 cases of L type, 2 cases of B type and 14 cases of T type) and biopsy cases of Hansen's disease. The changes in small blood vessels and capillaries were also observed using electron microscopy. Cardiac changes such as atrophy, hypertrophy, fibrosis and endocarditis, epicarditis and coronary sclerosis, were observed, and severe fibrosis was significantly more common in the T type cases. The heart weight tended to decrease with age in the T type cases, but such tendency was not observed in the L type cases, with some cases showing an increased heart weight. Marked atrophy, fibrosis, swelling and hyperplasia were observed in the peripheral nerves around the arteries in the epicardial adipose tissue and arterioles in the myocardium. These changes were caused by ageing of the vessels feeding the peripheral nerves, together with changes due to Hansen's disease, such as circulatory disturbance in vessels feeding the peripheral nerves, augmentation of vascular permeability and ischemic changes due to over-stratification of the basement membrane. Because these peripheral nerves were distributed around the arteries in the epicardial adipose tissue and they were probably vasomotor nerves. These results suggest that paralytic arterial changes may promote the ischemic cardiac disease or fibrosis.