ORIGINAL ARTICLES  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2003 December;44(6):685-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Ultrastructural changes of cardiac valves in bacterial endocarditis

Mirzaie M. ¹, Gunawan B. ², Schwartz P. ³, Coulibaly M. ¹, Schöndube F. ¹

¹ Department of Thoracic, Cardiac and Vascular Surgery, University Clinics Goettingen, Goettingen, Germany 2 Department of Pathology, University Clinics Goettingen, Goettingen, Germany 3 Institute for Anatomy, University Clinics Goettingen, Goettingen, Germany

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Aim. The prin­cipal objec­tive of ­this ­study was to doc­u­ment mor­pho­log­ical ­changes in ­valves ­with ­acute endo­car­ditis in ­order to ­gain fur­ther knowl­edge of the path­o­gen­esis of ­these dis­eases.
­Methods. Scan­ning and trans­mis­sion elec­tron micro­scopic inves­ti­ga­tions ­were car­ried out on ­explanted ­human ­heart ­valves to ­reveal ultra­struc­tural ­changes due to bac­te­rial endo­car­ditis.
­Results. Bac­te­rial inflam­ma­tion endo­car­ditis ­initially ­induced met­a­plasia of the endo­the­lial ­cells ­which ­then ­lose con­tact ­with ­each ­other. In the ­2nd ­phase of the dis­ease, the col­lagen ­fibres are system­at­i­cally ­removed ­whereby ­large cav­ities ­appear. In the ­3rd ­phase, loc­al­ised hyper­plasia of col­lagen ­fibres was ­observed ­often ­resulting in the devel­op­ment of veg­e­ta­tion. The ultra­struc­tural ­changes are uni­form and inde­pen­dent of the bac­te­rial spe­cies.
Con­clu­sion. Bac­te­rial endo­car­ditis is there­fore a set of com­plex inter­ac­tions ­between endo­the­lial ­cells and bac­teria ­which ­should be ­taken ­into con­sid­er­a­tion for the devel­op­ment of new ther­a­peutic ­approaches.