{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T21:57:09Z","timestamp":1769119029987,"version":"3.49.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Extravascular smooth muscle cells are often observed in the endocardium of human failing hearts. Here, we characterized the phenotype of those cells and investigated their physiological significance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We examined left ventricular biopsy specimens obtained from 44 patients with dilated cardiomyopathy and 6 nonfailing hearts. In Masson trichrome\u2013stained histological preparations, bundles of smooth muscle cells were seen localized in the endocardium in 23 of the 44 specimens (none of the 6 controls). These cells were immunopositive for \u03b1-smooth muscle actin, type 2 smooth muscle myosin, desmin, and calponin, but were negative for embryonic smooth muscle myosin, vimentin, fibronectin, and periostin. This profile is indicative of a late differentiation (contractile) smooth muscle phenotype. Electron microscopy confirmed that phenotype, revealing the cells to contain abundant myofilaments with dense bodies but little rough endoplasmic reticulum or Golgi apparatus. In the endocardial smooth muscle\u2013positive group, the left ventricular end-systolic volume index (73\u00b134 versus 105\u00b150 mL\/m\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.021), left ventricular peak wall stress (164\u00b147 versus 196\u00b143 dynes 10\n              <jats:sup>3<\/jats:sup>\n              \/cm\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.023), and left ventricular end-systolic meridional wall stress (97\u00b138 versus 121\u00b137 dynes 10\n              <jats:sup>3<\/jats:sup>\n              \/cm\n              <jats:sup>2<\/jats:sup>\n              ;\n              <jats:italic>P<\/jats:italic>\n              =0.036) were all significantly smaller, and the ejection fraction was larger (41\u00b18.8 versus 33\u00b19.3%;\n              <jats:italic>P<\/jats:italic>\n              =0.005) than in the endocardial smooth muscle\u2013negative group. However, no histological parameters differed between the 2 groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Endocardial smooth muscle cell bundles in hearts with dilated cardiomyopathy exhibit a mature contractile phenotype and may play a compensatory role mitigating heart failure by reducing left ventricular wall stress and systolic dysfunction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.114.001746","type":"journal-article","created":{"date-parts":[[2014,12,3]],"date-time":"2014-12-03T04:44:51Z","timestamp":1417581891000},"page":"149-155","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Phenotype and Physiological Significance of the Endocardial Smooth Muscle Cells in Human Failing Hearts"],"prefix":"10.1161","volume":"8","author":[{"given":"Hideshi","family":"Okada","sequence":"first","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genzou","family":"Takemura","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromitsu","family":"Kanamori","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Tsujimoto","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuko","family":"Goto","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itta","family":"Kawamura","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takatomo","family":"Watanabe","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Morishita","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagisa","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Ushikoshi","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuhiko","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuko","family":"Suzui","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Nishigaki","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; 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Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Minatoguchi","sequence":"additional","affiliation":[{"name":"From the Departments of Emergency and Disaster Medicine (H.O., K.M., H.U., S.O.) and Cardiology (H.K., A.T., K.G., I.K., T.W., N.M., T.T., M.K., K.N., A.M., S.M.), Gifu University Graduate School of Medicine, Gifu, Japan; Department of Internal Medicine, Asahi University, Mizuho, Japan (G.T.); and Division of Pathology, Gifu University Hospital, Gifu, Japan (T.M., N.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","first-page":"416","volume-title":"In Bloom and Fawcett: A Textbook of Histology","author":"Fawcett DW","year":"1976","unstructured":"Fawcett DW. 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Apoptosis mediates the decrease in cellularity during the transition between granulation tissue and scar. 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