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[Pathology of the heart and blood vessels in Hansen's disease].

There are few reports on the cardiovascular changes accompanying Hansen's disease, and many aspects remain unclear. We performed macroscopic and histologic examinations on the cardiovascular system in autopsy (47 cases of L type, 2 cases of B type and 14 cases of T type) and biopsy cases of Hansen's disease. The changes in small blood vessels and capillaries were also observed using electron microscopy. Cardiac changes such as atrophy, hypertrophy, fibrosis and endocarditis, epicarditis and coronary sclerosis, were observed, and severe fibrosis was significantly more common in the T type cases. The heart weight tended to decrease with age in the T type cases, but such tendency was not observed in the L type cases, with some cases showing an increased heart weight. Marked atrophy, fibrosis, swelling and hyperplasia were observed in the peripheral nerves around the arteries in the epicardial adipose tissue and arterioles in the myocardium. These changes were caused by ageing of the vessels feeding the peripheral nerves, together with changes due to Hansen's disease, such as circulatory disturbance in vessels feeding the peripheral nerves, augmentation of vascular permeability and ischemic changes due to over-stratification of the basement membrane. Because these peripheral nerves were distributed around the arteries in the epicardial adipose tissue and they were probably vasomotor nerves. These results suggest that paralytic arterial changes may promote the ischemic cardiac disease or fibrosis.