Cardiomyopathy with Prominent Autophagic Degeneration, Accompanied by an Elevated Plasma Brain Natriuretic Peptide Level Despite the Lack of Overt Heart Failure

Mieko SAIJO; Genzou TAKEMURA; Masahiko KODA; Hideshi OKADA; Shusaku MIYATA; Yasushi OHNO; Masanori KAWASAKI; Kunihiko TSUCHIYA; Kazuhiko NISHIGAKI; Shinya MINATOGUCHI; Koshi GOTO; Hisayoshi FUJIWARA

doi:10.2169/internalmedicine.43.700

Cardiovascular Diseases

Cardiomyopathy with Prominent Autophagic Degeneration, Accompanied by an Elevated Plasma Brain Natriuretic Peptide Level Despite the Lack of Overt Heart Failure

Mieko SAIJO, Genzou TAKEMURA, Masahiko KODA, Hideshi OKADA, Shusaku MIYATA, Yasushi OHNO, Masanori KAWASAKI, Kunihiko TSUCHIYA, Kazuhiko NISHIGAKI, Shinya MINATOGUCHI, Koshi GOTO, Hisayoshi FUJIWARA

Author information

Mieko SAIJO
Second Department of Internal Medicine, Gifu University School of Medicine
Genzou TAKEMURA
Second Department of Internal Medicine, Gifu University School of Medicine
Masahiko KODA
Second Department of Internal Medicine, Gifu University School of Medicine
Hideshi OKADA
Second Department of Internal Medicine, Gifu University School of Medicine
Shusaku MIYATA
Second Department of Internal Medicine, Gifu University School of Medicine
Yasushi OHNO
Second Department of Internal Medicine, Gifu University School of Medicine
Masanori KAWASAKI
Second Department of Internal Medicine, Gifu University School of Medicine
Kunihiko TSUCHIYA
Second Department of Internal Medicine, Gifu University School of Medicine
Kazuhiko NISHIGAKI
Second Department of Internal Medicine, Gifu University School of Medicine
Shinya MINATOGUCHI
Second Department of Internal Medicine, Gifu University School of Medicine
Koshi GOTO
Second Department of Internal Medicine, Gifu University School of Medicine
Hisayoshi FUJIWARA
Second Department of Internal Medicine, Gifu University School of Medicine

Keywords: autophagy, BNP, myocardial disease

JOURNAL OPEN ACCESS

2004 Volume 43 Issue 8 Pages 700-703

DOI https://doi.org/10.2169/internalmedicine.43.700

Details

Abstract

A 75-year-old man without overt heart failure showed an abnormally high level of brain natriuretic peptide (BNP) in plasma: 600 pg/ml. The left ventricular endomyocardial biopsy revealed prominent vacuolar degeneration in the myocytes, most of which were positive for PAS stain and BNP immunoreaction. Ultrastructurally, degenerative changes of myocytes were marked, such as deposits of glycogen and lipofuscin granules in the cytoplasm, but the most prominent finding was giant vacuoles containing degraded mitochondria, glycogen granules, myofibrils, and myelin-like structures (autophagosomes). This case may belong to one of the unclassified cardiomyopathies characterized by prominent autophagic vacuoles.

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