Abstract

Heart disease is common in both humans and chimpanzees, manifesting typically as sudden cardiac arrest or progressive heart failure. Surprisingly, although chimpanzees are our closest evolutionary relatives, the major cause of heart disease is different in the two species. Histopathology data of affected chimpanzee hearts from two primate centers, and analysis of literature indicate that sudden death in chimpanzees (and in gorillas and orangutans) is commonly associated with diffuse interstitial myocardial fibrosis of unknown cause. In contrast, most human heart disease results from coronary artery atherosclerosis, which occludes myocardial blood supply, causing ischemic damage. The typical myocardial infarction of humans due to coronary artery thrombosis is rare in these apes, despite their human-like coronary-risk-prone blood lipid profiles. Instead, chimpanzee ‘heart attacks’ are likely due to arrythmias triggered by myocardial fibrosis. Why do humans not often suffer from the fibrotic heart disease so common in our closest evolutionary cousins? Conversely, why do chimpanzees not have the kind of heart disease so common in humans? The answers could be of value to medical care, as well as to understanding human evolution. A preliminary attempt is made to explore possibilities at the histological level, with a focus on glycosylation changes.

Highlights

  • The commonest cause of human deaths in most developed and developing countries is atherosclerosis, a chronic progressive disease that affects large arteries, including the coronary blood vessels (Rosamond et al 2007)

  • 2002); autoimmune diseases (Sherer and Shoenfeld 2006; Soltesz et al 2007); accumulation of advanced glycation end-products arising from high blood glucose in diabetics (Goldin et al 2006), the ‘metabolic syndrome’ associated with high triglycerides and suppressed high density lipoprotein (HDL) levels (Eckel et al 2005; Meerarani et al 2006); genetic variations affecting the low density lipoprotein (LDL) receptor (Horton et al 2007); and, chronic inflammation associated with gingivitis, arthritis, obesity, or cigarette smoking (Haynes and Stanford 2003; Libby and Ridker 2004; Gonzalez-Gay et al 2006; Fantuzzi and Mazzone 2007; Yanbaeva et al 2007)

  • Coronary atherosclerosis frequently manifests as a ‘heart attack’, in which the patient becomes suddenly ill with chest pain, sweating and shortness of breath, resulting from obstruction of a major coronary artery that provides blood supply to the heart muscle (White and Chew 2008)

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Summary

Introduction

The commonest cause of human deaths in most developed and developing countries is atherosclerosis, a chronic progressive disease that affects large arteries, including the coronary blood vessels (Rosamond et al 2007). Coronary atherosclerosis frequently manifests as a ‘heart attack’, in which the patient becomes suddenly ill with chest pain, sweating and shortness of breath, resulting from obstruction of a major coronary artery that provides blood supply to the heart muscle (White and Chew 2008). Such acute coronary occlusion often results in ischemic death of the cardiac muscle regions that are perfused by the artery in question, and can even result in sudden death (Davies and Thomas 1984; Farb et al 1995; Virmani et al 2001). We provide preliminary evidence for differences in extracellular matrix and glycosylation patterns of human and great ape myocardium, which could potentially be relevant to understanding this difference

Materials and methods
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