Histohemijska, imunohistohemijska i morfometrijska analiza promena na srčanom mišiću kod heroinskih zavisnika

Abstract

In order to clarify the mechanism of heroin addicts death, besides changes in the lungs, which were most frequently studied, changes in the heart muscle were also observed. The weakening of the contractility of the myocardium and the binding of the connective tissue in the heart muscle are considered to be the basis for the development of possible pathogenetic mechanisms of dying. In order to define micro-morphological changes on the myocardium, histochemical, immunohistochemical and morphometric analysis determines the qualitative characteristics of cardiomyocytes and connective tissue, as well as the number of inflammatory cells in the myocardium (leucocytes, monocytes and macrophages, Tlymphocytes and mastocytes) of 42 cadavers whose death is in relation to the heroin abuse, and 10 cadavers from the control group. The quantification of these parameters was performed by measuring the thickness of the myocardiocyte and determining the percentage of connective tissue representation, and counting specific cell types in 30 visual fields in each of the 6 myocardial samples taken from the defined sites. The mean values were analyzed statistically. The connective tissue was statistically significantly present in the heroin addicts myocard in relation to the control group (p = 0.001). Cardiomyocytes were statistically significantly thicker in heroine addicts for p = 0.005. The number of leukocyte was significantly lower in the left ventricle compared to the right ventricle and the intraventricular septum (p = 0.02) for heroin addicts. Statistically significant differences between the sexes and between the groups defined by the length of heroin use were not recorded for the analyzed parameters. Cardiomyocyte hypertrophy, presence of connective tissue, and the presence of certain immune response cells indicate that prolonged use of the herion over time can lead to dysfunction of the heart muscle and heartbeat system, which may represent the cause of the death of heroin addicts.