Author + information
- Received May 22, 1993
- Revision received September 27, 1993
- Accepted November 29, 1993
- Published online April 1, 1994.
- Margareta Olsson, MD∗,
- Carl-Johan Dalsgaard, MD, PhD,
- Anders Haegerstrand, MD, PhD,
- Mårten Rosenqvist, MD, PhD,
- Lars Rydén, MD, PhD, FACC and
- Jan Nilsson, MD, PhD
- ↵∗Address for correspondence: Dr. Margareta Olsson, Department of Cardiology, Karolinska Hospital, S-104 01 Stockholm, Sweden.
Objectives. Cell-specific antibodies were used to identify immunocompetent cells in a comparison of valves from patients who had symptomatic tricuspid aortic stenosis with subjects who had no evidence of valvular heart disease.
Background. Nonrheumatic valvular aortic stenosis is the most common valvular heart disease among adults. The biologic processes involved in the development of this disease are poorly understood.
Methods. Tricuspid stenotic aortic valves were obtained from 19 patients undergoing surgery for nonrheumatic valvular aortic stenosis, and 10 control valves were collected at autopsy. The valves were fixed in formaldehyde, cryosectioned and stained with antibodies against fibroblasts, endothelial cells, macrophages, T lymphocytes and interlcukin-2 receptors. A subset of valves were also analyzed with antibodies against T-helper cells and cytotoxic T cells.
Results. Stenotic valves were characterized by a basal accumulation of calcium deposits and a cell-rich subendothelial thickening. The immunohistologic analysis indicated that the cells in the subendothelial connective tissue were fibroblasts. T lymphocytes appeared to be the most common cell type in the vicinity of the calcium deposits and were also found close to the endothelial lining of the valves. T-helper cells were more frequent than cytotoxic T cells. Expression of interleukin-2 receptors occurred at the same location as T lymphocytes. Control valves lacked subendothelial thickening and contained only few cells reacting with antibodies against lymphocytes and macrophages.
Conclusions. The presence of activated T lymphocytes in tricuspid stenotic valves suggests that immunologic mechanisms may be involved in the etiology of nonrheumatic aortic stenosis.
☆ This study was supported by grants from the Swedish Heart and Lung Foundation, the King Gustav V and Queen Victoria Foundation, the Swedish Medical Research Council (8311), the Knut and Alice Wallenberg Foundation, the Hans and Loo Osterman Foundation and the Karolinska Institute Foundation. Stockholm, Sweden.
- Received May 22, 1993.
- Revision received September 27, 1993.
- Accepted November 29, 1993.