Biomedical subjects

M Mukoyama

Publications and source records attributed to M Mukoyama.

At least 55 records · Page 3Linked to original sources

PubMed1994

Angiotensin converting enzyme and genetic hypertension: cloning of rat cDNAs and characterization of the enzyme.

Using genetic mapping approaches, a gene on chromosome 10, Bp1, has been identified in the stroke-prone spontaneously hypertensive rat (SHRSP) in the same region that contains the gene for angiotensin converting enzyme (ACE). Since ACE plays an important role in blood pressure regulation, the ACE gene is a leading candidate for Bp1. To examine the possibility that a structural abnormality of ACE exists in the SHRSP, we cloned and characterized the cDNAs for the Wistar-Kyoto rat (WKY) and SHRSP ACE. Both cDNAs encode a single polypeptide of 1,313 amino acid residues with an estimated molecular weight of 150.9 KDa. Five nucleotide differences were identified between the WKY and the SHRSP ACE cDNAs. One of these differences resulted in an amino acid substitution (Lys-207 in the WKY to Arg-207 in the SHRSP). But the enzymatic properties of partially purified ACE from the two strains were similar. Thus the data suggest that an alteration in the primary structure of rat ACE does not contribute to the hypertension in the SHRSP.

Amino Acid Sequence↗

PubMed1994

Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure.

BACKGROUND: B-type or brain natriuretic peptide (BNP) is a novel natriuretic peptide secreted from the heart that forms a peptide family with A-type or atrial natriuretic peptide (ANP), and its plasma level has been shown to be increased in patients with congestive heart failure. This study was designed to examine the sources and mechanisms of the secretion of BNP in comparison with those of ANP in control subjects and in patients with heart failure. METHODS AND RESULTS: We measured the plasma levels of BNP as well as ANP in 16 patients with dilated cardiomyopathy (11 men and 5 women; mean age, 59 years) and 18 control subjects (9 men and 9 women; mean age, 54 years) by sampling blood from the femoral vein, the aortic root, the anterior interventricular vein (AIV), and the coronary sinus using the newly developed immunoradiometric assay systems. In the control subjects, there was no significant difference in the plasma ANP level between the aortic root and the AIV (24.0 +/- 5.2 pg/mL versus 32.2 +/- 17.0 pg/mL), but there was a highly significant step-up of the level between the AIV and the coronary sinus (32.2 +/- 17.0 pg/mL versus 371.4 +/- 111.1 pg/mL, P < .001). In contrast, there was a significant step-up of the plasma BNP level between the aortic root and the AIV (8.6 +/- 6.4 pg/mL versus 19.0 +/- 11.5 pg/mL, P < .01) but not between the AIV and the coronary sinus (19.0 +/- 11.5 pg/mL versus 28.8 +/- 14.0 pg/mL). On the other hand, in patients with dilated cardiomyopathy, there was a significant step-up in the plasma ANP level between the aortic root and the AIV (280.6 +/- 183.7 pg/mL versus 612.3 +/- 431.6 pg/mL, P < .01) and between the AIV and the coronary sinus (612.3 +/- 431.6 pg/mL versus 1229.0 +/- 772.7 pg/mL, P < .01). There was a significant step-up in the plasma BNP level between the aortic root and the AIV (268.4 +/- 293.2 pg/mL versus 511.6 +/- 458.1 pg/mL, P < .01) but not between the AIV and the coronary sinus (511.6 +/- 458.1 pg/mL versus 529.7 +/- 455.3 pg/mL) in patients with dilated cardiomyopathy. The arteriovenous difference at the AIV of the plasma level of BNP had a significant positive correlation with left ventricular end-systolic volume index (r = 0.859, P < .001) and a significant negative correlation with left ventricular ejection fraction (r = -.735, P < .001). CONCLUSIONS: We conclude that (1) BNP is secreted mainly from the left ventricle in normal adult humans as well as in patients with left ventricular dysfunction, whereas ANP is secreted from atria in normal adult humans and also from the left ventricle in patients with left ventricular dysfunction; (2) secretion of BNP as well as ANP from the left ventricle increases in proportion to the severity of the left ventricular dysfunction, suggesting that the secretions of ANP and BNP from the left ventricle are regulated mainly by wall tension of the left ventricle; and (3) the peripheral plasma levels of ANP and BNP reflect the secretion rate of these hormones from the left ventricle and may be used as a marker of the degree of left ventricular dysfunction in patients with left ventricular dysfunction.

Aged↗

PubMed1994

Plasma concentration of atrial natriuretic peptide and brain natriuretic peptide during normal human pregnancy and the postpartum period.

Increases in blood volume are observed during normal gestation and these are reversed shortly after delivery. Although both atrial (A-type) natriuretic peptide (ANP) and brain (B-type) natriuretic peptide (BNP) have been described, the role of these peptides in pregnancy and the postpartum period are unclear. This study was designed to examine the effects of pregnancy, labour and delivery on plasma levels of ANP and BNP. Plasma levels of ANP and BNP were determined during normal pregnancy, 30 min after separation of the placenta (immediately postpartum) and between 5 and 72 h postpartum (late postpartum; puerperium). Since the assay sensitivity was 20 pg/ml plasma (for both ANP and BNP), values less than this were assigned a value of 20 pg/ml to calculate means. Plasma levels of ANP and BNP were significantly higher at term pregnancy than during the first trimester (ANP increased from 20 +/- 0.2 to 57 +/- 10 pg/ml (S.E.M.), P < 0.001; BNP increased from 25 +/- 2 to 49 +/- 9 pg/ml, P < 0.01). The plasma level of ANP then rose to 157 +/- 38 pg/ml 30 min after separation of the placenta, being significantly (P < 0.01) higher than that seen at term pregnancy. It declined significantly (P < 0.001) to 32 +/- 3 pg/ml in the late postpartum period. In contrast, the plasma level of BNP 30 min after separation of the placenta was 80 +/- 25 pg/ml, and increased to 116 +/- 17 pg/ml in the late postpartum period, significantly (P < 0.01) higher than the level at term pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

[A case of malignant lymphoma, highly suspected to be of pancreatic origin, with multiple nodular hepatic invasions].

We reported a rare case of malignant lymphoma, highly suspected to be of pancreas origin with multiple nodular hepatic invasions. A 63-year-old man visited our hospital on May 24 1990, complaining of anorexia. In spite of high serum levels of LDH and amylase, abdominal ultrasonography (US) showed no significant lesions. Forty days later, he was admitted because of the loss of weight and the appearance of abdominal pain with marked hepatomegaly, exhibiting cachexia. Abdominal US and computed tomography visualized a tumor of pancreas with multiple nodular space-occupying lesions in the liver. In several days, jaundice and ascites appeared with progressive deterioration. Angiography showed no tumor vascularity nor vascular stain in pancreas and liver, suggesting a non-epithelial malignancy. Mitomycin C and Epi-adriamycin, given to the patient via the celiac artery, brought about a remarkable shrinkage of the abdominal tumor. Subsequent systemic chemotherapies and occasional intra-arterial chemotherapies resulted in the disappearance of abdominal tumor clinically. However, at the end of April 1991, signs of CNS involvement were observed, and he died on June 7, 1991. Autopsy revealed that malignant lymphoma, of diffuse large cell type, had invaded the subarachnoidal cavity without any evidence of invasion of the abdomen or other sites except regional necrotic lesion in the pancreas. These findings strongly suggested that the patient suffered from malignant lymphoma of pancreas origin with multiple nodular hepatic invasions.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1994

Molecular biology of angiotensin receptors: target for drug research?

UNLABELLED: Angiotensin II receptors: Angiotensin II is a key regulator of cardiovascular homeostasis. At least two distinct angiotensin II receptor subtypes are defined, on the basis of their differential pharmacological and biochemical properties, and designated as type 1 (AT1) and type 2 (AT2) receptors. AT1 subtypes: Recent cloning has revealed that the AT1 type belongs to a seven-transmembrane, G protein-coupled receptor superfamily. The AT1 receptor comprises two isoforms, AT1a and AT1b, which are strikingly similar in amino acid structure, pharmacological specificity and signal transduction mechanism. To date, the evidence indicates that almost all of the known effects of angiotensin II in adult tissues are attributable to the AT1 receptor. AT2 subtype: Much less is known about the function of the AT2 receptor, but its abundant expression in fetal tissues, immature brain, skin wounds, and atretic ovarian follicles suggest that it affects growth and development. The AT2 receptor complementary (c)DNA has recently been cloned. It encodes a 363 amino acid protein with unique tissue distributions and developmental patterns. It is 34% identical in sequence to the AT1 receptor, sharing a seven-transmembrane domain topology. CONCLUSIONS: Further research in defining the functions of the AT1 and AT2 receptor subtypes in cardiovascular regulation will provide new opportunities for new drug discovery and for the characterization of angiotensin II antagonists.

Angiotensin II↗

PubMed1993

Cloning of cDNA and analysis of the gene for mouse angiotensin II type 2 receptor.

A cDNA clone encoding the mouse angiotensin receptor subtype 2 (AT2 receptor) was isolated from a mouse fetal cDNA library. Mouse AT2 receptor full-length cDNA contains a 1089-base-pair open reading frame which encodes a protein of 363 amino acid residues. Hydropathy analysis reveals seven putative transmembrane domains. Specific binding of [125I]CGP42112A was demonstrated in membranes of COS-7 cells transfected with the cDNA. Scatchard analysis and ligand displacement profile were typical of the AT2 receptor. Northern blot and reverse transcription-polymerase chain reaction analyses demonstrated that AT2 receptor mRNA was expressed abundantly in fetus and in a lesser amount in adult brain. Analysis of the mouse AT2 receptor gene reveals that the mouse AT2 receptor locus exists as a single copy in the genome, and that the gene does not contain introns in the coding region.

Angiotensin II↗

PubMed1993

Expression cloning of type 2 angiotensin II receptor reveals a unique class of seven-transmembrane receptors.

Angiotensin II acts on at least two distinct receptor subtypes (AT1 and AT2). Most known effects of angiotensin II in adult tissues are attributable to the AT1 receptor. The function of AT2 receptor is undefined, but its abundant expressions in fetal tissues, immature brain, skin wound, and atretic ovarian follicles suggest a role in growth and development. Previous studies suggested that AT2 receptor may not be G protein-coupled. Here, from a rat fetus expression library, we cloned a cDNA encoding a unique 363-amino acid protein with pharmacological specificity, tissue distribution, and developmental pattern of the AT2 receptor. It is 34% identical in sequence to the AT1 receptor, sharing a seven-transmembrane domain topology. A review of prior data on other receptors suggests that this receptor may belong to a unique class of seven-transmembrane receptors (including somatostatin SSTR1, dopamine D3, and frizzled protein Fz) for which G protein coupling has not been demonstrated. All members of this class exhibit fetal and developmental and/or neuronal-specific expression. A conserved motif in the third intracellular loop, distinguishing this class from "classical" G protein-coupled receptors, may mediate novel intracellular effects.

Amino Acid Sequence↗

PubMed1993

Brain natriuretic peptide levels in the umbilical venous plasma are elevated in fetal distress.

We measured, by a specific radioimmunoassay, brain-natriuretic-peptide-like immunoreactive (BNP-LI) levels in the umbilical venous and arterial plasma of normal and distressed newborns. The indicated BNP-LI level in umbilical arterial plasma of normal newborns (3.5 +/- 0.9 fmol/ml, mean +/- SEM, n = 10) was significantly higher than that in umbilical venous plasma of the same newborns (2.2 +/- 0.5 fmol/ml). In the distressed newborns at term, the indicated BNP-LI level in umbilical venous plasma was 62.2 +/- 25.7 fmol/ml (n = 4), which was 19-fold higher than that of elective cesarean section cases (3.2 +/- 0.3 fmol/ml, n = 6; p < 0.05). The findings demonstrated that BNP was present in the human fetal circulation and that the plasma BNP level was elevated under fetal distress conditions.

Atrial Natriuretic Factor↗

PubMed1993

Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure.

BACKGROUND: The plasma levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are increased in relation to the severity of congestive heart failure (CHF). This study was designed to examine whether the secretion patterns of ANP and BNP vary with underlying cardiac disorders of CHF with different degrees of overload in atria and ventricles. METHODS AND RESULTS: We measured plasma levels of ANP and BNP in the aorta in 20 patients with mitral stenosis (MS) in whom atria are mainly overloaded, 30 patients with dilated cardiomyopathy (DCM) in whom both atria and ventricles are overloaded, and 20 control subjects during cardiac catheterization. Pulmonary capillary wedge pressure (PCWP) was significantly higher in the MS and DCM groups (16.7 +/- 4.7 mm Hg and 15.1 +/- 7.7 mm Hg, respectively) than in the control group (7.2 +/- 1.1 mm Hg, p < 0.01), whereas there was no significant difference between the MS and DCM groups. Left ventricular end-diastolic pressure (LVEDP) was significantly higher in the DCM group than in the MS group (16.4 +/- 7.8 mm Hg versus 7.6 +/- 2.0 mm Hg, p < 0.01), and the level was comparable between the MS and control groups (7.6 +/- 2.0 mm Hg versus 6.8 +/- 1.2 mm Hg, p = NS). The plasma ANP level was significantly higher in the MS and DCM groups (356 +/- 169 pg/ml and 331 +/- 323 pg/ml, respectively) than in the control group (98 +/- 41 pg/ml, p < 0.01), whereas there was no significant difference between the MS and DCM groups. The plasma BNP level was significantly higher in the DCM group than in the MS group (333 +/- 405 pg/ml versus 147 +/- 54 pg/ml, p < 0.01), and the level was significantly higher in the MS group than in the control group (147 +/- 54 pg/ml versus < 10 pg/ml, p < 0.01). The plasma levels of ANP and BNP had a highly positive correlation with PCWP in the DCM group (p < 0.01). On the other hand, in the MS group, the plasma ANP level had a highly significant correlation with PCWP (p < 0.01) but the plasma BNP level did not. CONCLUSIONS: We conclude that plasma levels of BNP mainly reflect the degree of ventricular overload and that the secretion patterns of ANP and BNP vary with underlying cardiac disorders of CHF with different degrees of overload in atria and ventricles.

Adult↗

PubMed1993

Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction.

BACKGROUND: Brain natriuretic peptide is a novel natriuretic peptide that is secreted predominantly from the ventricles, and its plasma levels have been shown to be markedly increased in patients with chronic congestive heart failure. This study was designed to examine the plasma levels of brain natriuretic peptide as well as atrial natriuretic peptide in patients with acute myocardial infarction. METHODS AND RESULTS: We examined the plasma levels of brain natriuretic peptide as well as atrial natriuretic peptide in 50 consecutive patients (36 men and 14 women; mean age, 66 years) with acute myocardial infarction over the time course of 4 weeks. The plasma level of brain natriuretic peptide was significantly increased on admission in patients with acute myocardial infarction compared with controls (92 +/- 28 versus 5.2 +/- 0.5 pg/mL, P < .01) and reached the peak level of 319 +/- 58 pg/mL at 16.4 +/- 0.7 hours after admission. Thereafter, the level decreased and then again increased, forming the second peak of 277 +/- 66 pg/mL on day 5. The level then decreased gradually but was still much higher in the fourth week than that of controls (149 +/- 47 versus 5.2 +/- 0.5 pg/mL, P < .001). On the other hand, the plasma atrial natriuretic peptide level already had been increased at the time of admission compared with controls (116 +/- 14 versus 39.5 +/- 2.6 pg/mL, P < .01) and decreased thereafter, again increasing and making a small peak on day 2 to 3. The time course of the plasma brain natriuretic peptide level could be divided into two patterns: a monophasic pattern with one peak at about 16 hours after admission and a biphasic pattern with two peaks at about 16 hours and 5 days after admission. There were significantly more patients with anterior infarction, congestive heart failure, higher level of maximal creatine kinase-MB isoenzyme, and lower left ventricular ejection fraction in the biphasic group than in the monophasic group. CONCLUSIONS: We conclude that the plasma level of brain natriuretic peptide is increased markedly in patients with acute myocardial infarction and may reflect the degree of left ventricular dysfunction in these patients.

Aged↗

PubMed1993

Ventricular expression of brain natriuretic peptide in hypertrophic cardiomyopathy.

BACKGROUND: Brain natriuretic peptide (BNP), as a cardiac hormone, is expressed together with atrial natriuretic peptide (ANP) in the ventricles in congestive heart failure. However, the ventricular expression of BNP in hypertrophic cardiomyopathy (HCM) with normal systolic function is still unclear. METHODS AND RESULTS: The study population consisted of 39 HCM patients with asymmetric septal hypertrophy and 10 control subjects without any specific cardiac disease. Eleven cases of HCM were obstructive (HOCM), and the other 28 cases were nonobstructive (HNCM). All of these patients had a normal ejection fraction. Immunohistochemical analysis of endomyocardial biopsy specimens with specific monoclonal antibodies showed BNP immunoreactivity in the HOCM group (5/10, 50%) but not in the HNCM group (0/22) or in control subjects (0/5). In HOCM, left ventricular end-diastolic pressure was significantly higher in the BNP-positive patients than the BNP-negative patients. Histological changes such as myocardial fiber disarray, hypertrophy of myocytes, and fibrosis were greater in BNP-positive patients than BNP-negative patients in HCM. However, the expression had no significant relation with other clinical parameters. The elevation of the BNP plasma level versus control subjects was marked in both HOCM (85-fold) and HNCM (23-fold). By contrast, the elevation of the ANP plasma level versus control subjects was mild in HOCM (5.7-fold) and HNCM (4.2-fold). The ratio of BNP level to ANP level was higher in HOCM (4.16) than in HNCM (1.46) and control subjects (0.28), and it was higher than the ratio previously reported for severe congestive heart failure (1.72). CONCLUSIONS: These findings suggest that BNP is expressed in the ventricular myocytes of HCM with normal systolic function. In HOCM, ventricular expression of BNP may be augmented in response to both obstruction and diastolic dysfunction.

Adult↗

PubMed1993

Multiple autocrine growth factors modulate vascular smooth muscle cell growth response to angiotensin II.

Angiotensin (Ang) II stimulates hypertrophic growth of vascular smooth muscle cells (VSMC). Accompanying this growth is the induction of the expression of growth-related protooncogenes (c-fos, c-jun, and c-myc), as well as the synthesis of the autocrine growth factors, such as PDGF-A and TGF-beta 1. In this study, we demonstrate further that Ang II also induces the synthesis of basic fibroblast growth factor (bFGF), a potent mitogen for VSMC. To examine how these factors interact to modulate the growth response of VSMC to Ang II, we used antisense oligomers to determine the relative contribution of these three factors. Treatment of confluent, quiescent smooth muscle cells with specific antisense oligomers complementary to bFGF, PDGF-A, and TGF-beta 1 efficiently inhibited the syntheses of these factors. Our results demonstrate that in these VSMC, TGF-beta 1 affects a key antiproliferative action, modulating the mitogenic properties of bFGF. Autocrine PDGF exerts only a minimal effect on DNA synthesis. An imbalance in these signals activated by Ang II may result in abnormal VSMC growth leading to the development of vascular disease.

3T3 Cells↗

PubMed1993

Low doses of endothelin-1 inhibit atrial natriuretic peptide secretion.

To clarify the interaction between endothelin-1 (ET-1) and atrial natriuretic peptide (ANP), the effects of ET-1 on ANP secretion were investigated in isolated perfused rat hearts and in conscious unrestrained rats. Perfusion with 10(-9) M ET-1 stimulated ANP secretion from the isolated perfused rat heart. However, 10(-10) M ET-1 significantly decreased ANP secretion for the initial 15 min of the perfusion period. The perfusion with 10(-11) M ET-1, which is near the plasma level of ET-1 (2 x 10(-12) M), inhibited ANP secretion throughout the perfusion period. The perfusion of 10(-12) M ET-1 slightly decreased ANP secretion. After the ET-1 perfusion period, ANP secretion increased in proportion to ET-1 dose. The inhibitory action of ET-1 on ANP secretion was almost abolished by simultaneous perfusion of indomethacin, a cyclooxygenase inhibitor, but not by methylene blue, an inhibitor of soluble guanylate cyclase. In conscious unrestrained rats the iv infusion of 1 pmol/kg.min ET-1, which doubled the plasma ET-1 level, slightly but significantly decreased the plasma ANP level 5 and 10 min after the initiation of the infusion. The infusion of 10 and 30 pmol/kg.min ET-1 increased the plasma ANP level. These results demonstrate that low doses of ET-1 exert an inhibitory and short-acting action on ANP secretion from the heart, although high doses of ET-1 exert stimulating and long-lasting action, and suggest that prostanoids are involved in this inhibitory action.

Animals↗

PubMed1993

Brain natriuretic peptide is present in the human amniotic fluid and is secreted from amnion cells.

The presence and biochemical characteristics of human brain natriuretic peptide (hBNP) in the amniotic fluid at various gestational ages were investigated. The hBNP-like immunoreactivity (hBNP-LI) levels in amniotic fluid, determined by RIA, were 118.7 +/- 57.6 pmol/L (mean +/- SEM; n = 5) and 107.7 +/- 8.7 pmol/L (n = 9) in the first and second trimesters of pregnancy, respectively; it was significantly decreased to 28.4 +/- 5.1 pmol/L (n = 9) in the third trimester. However, human atrial natriuretic peptide-like immunoreactivity (hANP-LI) was not detected (< 0.3 pmol/L) in any of these samples. Northern blot analysis demonstrated hBNP mRNA in human amnion tissue. Moreover, cultured amnion cells secreted a significant amount of hBNP-LI (100-200 fmol/10(6) cells/day), but not hANP-LI, into the culture medium. The synthesis of hBNP in cultured amnion cells was further confirmed using the polymerase chain reaction. High performance gel permeation chromatography of hBNP-LI extracted from human amniotic fluid and the culture medium of amnion cells revealed that the predominant molecular form of hBNP-LI in both samples was the hBNP precursor, with an approximate mol wt of 12 kilodaltons. These findings indicate that hBNP is present in the human amniotic fluid, and that amnion cells synthesize hBNP and secrete it into the amniotic cavity.

Amniotic Fluid↗

PubMed1993

Hereditary distal dominant amyotrophy followed by spastic paraplegia.

Clinical, neurophysiological and neuropathological investigations were performed on five patients from two families with autosomal dominant distal amyotrophy followed by spastic paraplegia and with a positive history in two generations of these two families. All cases in the two families had a benign clinical course, although two mothers could not walk without support at around 60 years old. Neurophysiological studies revealed normal maximum conduction velocities of peripheral sensory and motor nerves, and the central spinal sensory pathway. Distribution of motor nerve conduction velocities in the ulnar nerve had a normal pattern except for one patient who had severe deformities of the cervical vertebrae. The biopsied sural nerve disclosed no distinct abnormalities in any cases. From these results, we confirmed preservation of the myelinated nerve fibers of motor and sensory peripheral nerves.

Adult↗

PubMed1993

[The life spans, cause of death and pathological findings of Fukuyama type congenital muscular dystrophy--analysis of 24 autopsy cases].

The case cards for autopsied patients with Fukuyama type congenital muscular dystrophy (FCMD) which included clinical data and pathological findings were filled in 10 national hospitals and 2 other institutes in Japan. The cards of 24 patients who died between 1978 and 1991 were collected and analysed for this study. The ages at death ranged from 2 to 27 years with a mean of 14.29 +/- 6.18 years and represented a nearly unimodal distribution. The age at death in the 12 patients who died before 1983 ranged from 2 to 21 years and averaged 11.58 +/- 5.11 years, whereas the 12 patients who died after 1984 ranged from 3 to 27 years of age and averaged 17.00 +/- 6.44 years. The latter group lived significantly longer than the former (p < 0.05). Pulmonary infection was a more frequent cause of demise in the group of patients who died before 1983 than in those who died after 1984 (83.3% vs 25.0%). On the other hand, cardiac failure was a more common cause of death in the latter group (8.3% vs 50.0%). These data on the life spans and cause of death of FCMD were similar to those studied of Duchenne muscular dystrophy by Mukoyama et al (1984, 1986, 1987).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Autopsy analyses of the muscular dystrophies.

Life span, causes of death, weight of heart, liver, brain, and main pathological changes of internal organs were analysed on 329 autopsy cases of muscular dystrophies. These included 249 cases of Duchenne muscular dystrophy (DMD), 3 Becker muscular dystrophies (BMD), 14 limb-girdle muscular dystrophies (LGMD), 3 fascioscapulohumeral muscular dystrophies (FSH), 18 Fukuyama type congenital muscular dystrophies (FCMD) and 17 myotonic dystrophies (MyD). In DMD the life span has definitely prolonged in recent years. Pulmonary infection, which was once the major cause of death, has greatly decreased in recent years. Instead, respiratory and cardiac failures caused by dystrophic changes of respiratory and cardiac muscles were more closely related to the causes of death in many recent cases. Myocardial fibrosis was observed in most of the patients with DMD, BMD, LGMD, FCMD and MyD. The distribution of cardiac lesions was similar in BMD, LGMD and FCMD as in DMD. In MyD the disorders involved more frequently conductive muscles resulting in arrhythmias. The dystrophic cardiomyopathy seemed to be a part of the essential changes in all types of muscular dystrophy, although different in intensity and rate of morbidity. Alzheimer's neurofibrillary changes were observed in the brain of some cases of FCMD and MyD, suggesting the possibility of precocious aging of the brain in some patients of the muscular dystrophies.

Adolescent↗

PubMed1993

Ventricular expression of atrial and brain natriuretic peptides in dilated cardiomyopathy. An immunohistocytochemical study of the endomyocardial biopsy specimens using specific monoclonal antibodies.

Although brain natriuretic peptide is expressed in ventricles of failing hearts including dilated cardiomyopathy, its morphological localization is still unclear. In this study, we analyzed the immunohistocytochemical localization of atrial and brain natriuretic peptides in ventricles of dilated cardiomyopathy at both light and electron microscopic levels. Ventricular specimens were obtained by endomyocardial biopsy in 31 patients (26 with dilated cardiomyopathy and 5 controls without any specific cardiac disease). By light microscopic immunohistochemistry using specific monoclonal antibodies, all (26 of 26) of the left ventricular endomyocardial biopsy specimens and 31% (8 of 26) of the right ventricular specimens showed immunoreactivity for both of these natriuretic peptides in dilated cardiomyopathy. In contrast, none of the normal controls showed immunoreactivity for either of these peptides. The percentage of atrial natriuretic peptide-containing or brain natriuretic peptide-containing myocytes in the left ventricular specimens showed an inverse correlation with the left ventricular ejection fraction (r = -0.72 and r = -0.69, respectively). By electron microscopy, we identified specific secretory granules in ventricular myocytes from patients with dilated cardiomyopathy, but not in those from normal controls. Double immunocytochemistry using a two-face immunogold staining method revealed brain natriuretic peptide colocalized with atrial natriuretic peptide in the same ventricular granules. These findings suggest that brain natriuretic peptide is expressed in ventricular myocytes in response to hemodynamic stress in dilated cardiomyopathy. Brain natriuretic peptide may be, at least in part, synthesized simultaneously and secreted together with atrial natriuretic peptide by granules from failing ventricles, although the secretory turnover is different between these two peptides.

Adult↗