Pathomorphological changes of liver parenchymal structures in patients with different duration of arterial hypertension

Abstract

Background. The current level of understanding of the pathogenetic mechanisms of interaction between the liver and the cardiovascular system does not allow us to ignore the state of one system when the other is affected. The purpose of the research is to make a morphometric assessment of the parenchymal structures of the liver in patients with different duration of arterial hypertension. Materials and methods. The study used autopsy material from the liver of 47 deceased patients, of whom 40 people suffered from arterial hypertension, and 7 people did not have cardiovascular diseases. The studied material was prepared according to a standard histological technique, with the help of a video morphometry system, the cross-sectional area of the nucleus, cytoplasm, the nuclear-cytoplasmic ratio of hepatocytes was measured, the width of the Disse spaces and sinusoidal capillaries in the hepatic lobules was measured at x800 magnification. Results. In the comparison group (without pathology of the cardiovascular system), macro- and microscopically, the liver had a typical structure. During the examination of the liver of deceased persons suffering from arterial hypertension, hyalinosis and sclerosis were detected in the vessels of the portal tract, fatty dystrophy was expressed, signs of a chronic inflammatory process were sometimes detected in the portal tracts - lymphohistiocytic infiltration, in some microslides deposits of hemosiderin and lipofuscin in the liver parenchyma, some dilations of the Disse spaces were determined. The morphometric parameters of hepatocytes of patients with arterial hypertension, having no significant statistical differences from the comparison group, showed a significant variation, which indicates pathological changes in the liver parenchyma. Assessing the parameters of the Disse spaces and the lumens of the sinusoidal capillaries, a significant expansion of the capillary lumen was noted as early as 5 years after the onset of arterial hypertension. Disse’s spaces reacted to the pathogenic factor later and significantly expanded only in groups of patients with a duration of arterial hypertension of more than 10 years. Conclusions. Long-term exposure of arterial hypertension to the liver parenchyma primarily leads to a significant dilation of the lumens of the sinusoid capillaries and Disse spaces. A trend of a decrease in the area of nuclei and a change in the area of the cytoplasm due to the impact of arterial hypertension was recorded. A more significant spread of measured parameters in the groups of patients suffering from hypertension indicates the involvement of hepatocytes in the pathological process.

Keywords

• liver
• arterial hypertension
• hepatocyte
• disse space
• sinusoidal capillaries
• morphometry