Amyloid Deposit in the Aged Heart

• Published in: Nihon Rōnen Igakkai zasshi Vol. 15; no. 1; pp. 55 - 60
• Main Authors: Shimada, Hiroyuki, Ueda, Keiji, Sugiura, Masaya, Ohkawa, Shinichiro, Otsu, Shoichi, Hiraoka, Keisuke
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 01.01.1978
• Subjects: Aged; Aging; Amyloid - metabolism; Female; Humans; Male; Middle Aged; Myocardium - metabolism; Myocardium - pathology
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.15.55

A clinicopathological study was made on the amyloid deposition in the aged heart as an index of aging. A total of 108 consecutive autopsy cases (57 men and 51 women), ranging in age from 54 to 94 years was the subject. Three blocks from (1) anterior wall of the left ventricle, (2) interatrial and interventricular septum, (3) junction between the superior vena cava and right auricle, were stained by hematoxylin and eosin, azan and pyridine-congo red, and amyloid was identified by fluorescence and green birefringence. Amyloid was positive in 23 among 57 men (40.4%), 25 among 51 women (49%), 48 among a total of 108 cases (44.4%). Sex difference was not significant. Increase of the incidence from 41% in the 7th and 8th decades to 50% in the 9th and 10th decades was statistically not significant. Amyloid deposits were found in myocardium in 41 cases, mid to small coronary arteries in 30, and endocardium in 4. Myocardial deposits were found in the atrial septum in 32, pectinate muscle of the right atrium in 23, left ventricle in 4, sinoatrial (SA) node in 3, and atrioventricular (AV) conduction system in 2. Incidence of conduction disturbances was compared between amyloid positive and negative groups, that is 58% (28 among 48 cases) and 52% (31 among 60 cases) was not significant. In 10 cases conduction system was examined by serial sections, and only 1 of them with left axis deviation (LAD) showed small amount of amyloid in the SA node and right bundle branch, giving no corresponding deposition. Comments: Aged heart is the predilection site of the amyloid deposition. Using a definition of cardiac amyloidosis as a state producing symptoms such as congestive heart failure or conduction disturbances, our results of 44.4% was the incidence of amyloid deposit, not amyloidosis. Deposition of the amyloid in the conduction system occurred rarely wish few conduction disturbances. Serial sections of the conduction system in various conduction disturbances were negative to the amyloid. From above results, it was concluded that (1) the incidence of amyloid deposit was high in the aged heart, but cardiac amyloidosis was rare, (2) the most of the conduction disturbances found in the aged were not related to the amyloid.