Immunophenotypical pleomorphism expression in sudden cardiac death

Vol. 49 No. 3, 2008


M. Ceauşu, C. Curcă, Carmen Ardeleanu, D. Dermengiu

This study was undertaken to assess several histopathological and immunohistochemical markers regarding some lesional aspects of ischemically and hypoxically damaged myocardium in sudden cardiac death. Tissue samples of myocardium from 17 middle age and young patients with sudden cardiac death, following acute or chronic cardio(myo)pathies, were analyzed using standard HE stain and indirect tristadial ABC peroxidase immunohistochemical method, for a panel of 12 antibodies grouped in three categories: antibodies involved in programmed cell death (bcl-2, p53, Fas/CD95, Fas-L, bax, caspase 9), muscular markers (Myo-D1, myogenin, desmin, actin) and growth factor receptors (b-FGF, VEGF, NGF). Myogenin was more sensitive in identifying the ischemic perilesional myocardic fibers than Myo-D1, but less specific, while desmin had a greater sensitivity than myogenin and Myo-D1 taken separately, but with no specificity for myocardic fibers. Fas-L, caspase 9 and bax were expressed in more than 75% of cases in perilesional residual cardiomyocytes, correlating to each other (r = 0.45, respectively r = 0.6, p<0.05). b-FGF, VEGF and NGF had a focally variable expression in subendocardial and subepicardial cardiomyocytes and were statistically independent. Even if there was a polymorphic expression of antibodies in the studied batch, our findings indicate that some parameters (Fas-L, b-FGF, Myo-D1) might be independent markers for predicting sudden cardiac death in patients with previously damaged myocardium.

Corresponding author: Mihai Ceauşu, MD, PhD, e-mail:

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