Abstract 17586: Effect of Myocardial Infiltration of Dendritic Cells, Macrophages and T Lymphocytes on Long-term Prognosis in Patients With Dilated Cardiomyopathy
Background: Dilated cardiomyopathy (DCM) is considered to be multifactorial, and its disease progression is diverse in each patient clinically. Recent reports have provided suggestive pathological evidence that persistent inflammation in myocardium may be involved in the process of worsening cardiac function. Purpose of this study is to clarify the long-term prognostic significance of infiltrative immune-mediated cells in patients with DCM.
Method: A total of 203 consecutive patients with heart failure, who underwent right ventricular endomyocardial biopsy in 2005 and 2006 at our institution, were reviewed. Of them, 80 subjects, consequently diagnosed as DCM by excluding ischemic cardiomyopathy, hypertrophic cardiomyopathy, myocarditis and secondary cardiomyopathy, were enrolled. We stained biopsy samples with antibodies specific for CD3 (T lymphocytes), CD68 (macrophages), CD163 (M2 macrophages), and CD209 (dendritic cells) to count the number of infiltrating cells. We also obtained each patient’s clinical data in medical records for up to 8 years (mean 6.2 years).
Results: During the observation period, 11 patients (14%) died (Group D). Those patients showed no different baseline characteristics at diagnosis, including sex, age, LV ejection fraction, serum creatinine and plasma BNP levels, past history and medications from those who survived (Group S). The number of infiltrating CD68 and CD163 was greater in Group D compared to Group S (24±4 vs. 14±1/mm2, p=0.01 and 13±2 vs. 7±1 /mm2, p=0.006, respectively). The number of CD3 was higher in Group D than Group S (15±3 vs. 9±1/mm2, p=0.048). Furthermore, the number of CD209 was positively correlated with that of CD163 (r=0.50, p<0.001). Additionally, the increased level of plasma BNP was positively correlated with the number of CD163 both at 1 year (r=0.33, p=0.03) and 5 years (r=0.35, p=0.04).
Conclusions: Despite similar clinical background, patients with poor prognosis showed more infiltrating macrophages and T cells into myocardium at diagnosis of DCM. In addition, increased myocardial infiltration of M2 macrophages was associated with increased dendritic cells infiltration and plasma BNP level, suggesting a possible role of these immune cells in the worsening process of DCM.
Author Disclosures: T. Nakayama: None. Y. Sugano: None. M. Takigami: None. T. Yokokawa: None. T. Nagai: None. H. Kanzaki: None. K.O. Ogo: None. T. Matsuyama: None. Y. Ikeda: None. H.I. Ueda: None. T. Nakatani: None. S. Yasuda: None. H. Ogawa: None. T. Anzai: None.
- © 2014 by American Heart Association, Inc.