Pulmonary arteriolar muscularization in coal workers' pneumoconiosis and its correlation with right ventricular hypertrophy.
Hu-N; Vallyathan-V; Green-FH; Weber-KC; Laqueur-W
Arch Pathol Lab Med 1990 Oct; 114:1063-1070
The relationship between right ventricular hypertrophy (RVH) and chronic lung diseases in mine workers and the thickness of the walls of small pulmonary arteries was examined. Lungs, hearts, and pulmonary arterioles were obtained at autopsy from 72 coal miners. The percentage of medial thickness (PMT) in workers with simple coal workers' pneumoconiosis (CWP) and other chronic lung diseases (CLD) was increased compared with comparisons. A positive correlation was seen between PMT and years of underground mining as well as between the right ventricular weight as a percentage of the left ventricular weight (RV/LV ratio) and PMT. Coal miners had significantly higher incidences of emphysema than nonminers, and in a group of miners with the most severe emphysema, a positive correlation was seen between RV/LV ratio and emphysema severity. The PMT was associated with a higher incidence of RVH than CWP, but when CWP was seen along with CLD, the incidences of RVH increased. The incidence of RVH, and the PMT value, increased when progressive massive fibrosis was complicated by CLD. Microscopic evaluation of pulmonary arterioles from miners demonstrated narrowing of the lumen associated with medial muscular hypertrophy and fibromuscular proliferation of the intima, along with infiltration of coal dust containing macrophages, medial muscular hypertrophy and elastic lamina reduplication in areas not associated with fibrosis. The authors conclude that the muscular thickening seen in the pulmonary arterioles of miners may provide a framework for the development of ventricular hypertrophy.
NIOSH-Author; Mine-workers; Coal-miners; Coal-dust; Coal-workers-pneumoconiosis; Cardiovascular-system-disorders; Occupational-exposure; Postmortem-examination; Respiratory-system-disorders; Underground-miners
Archives of Pathology and Laboratory Medicine