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Correspondence to Author: Hiroki Kajihara, MD, PhD^a) and Kazuhiro Sentani, MD, PhD^b) .. 

a)Emeritus Professor of Hiroshima Univ, Hiroshima, Japan.
b)Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University.

DOI: 10.52338/jocd.2026.4791

Abstract:

The mast cell counts in the adventitia of large subepicardial coronary arteries and in the myocardium of both the right and left ventricles were determined in a patient (age 40 years, male) with eosinophilic coronary periarteritis (ECPA) and a patient (age 66 years, male) without cardiac inflammation. A large number of mast cells (96.0/mm2) were found with numerous eosinophils in the adventitia of the inflamed subepicardial coronary artery of patients with ECPA. On the other hand, in a patient (age 66 years, male) without coronary inflammation, the average mast cell count was normal (7.0±0.8 mast cell /mm2).The mast cell counts of the right and left myocardia of patients with ECPA were 13.6±4.2 mast cell / mm2 and 13.8±2.0 mast cell /mm2, respectively, and those of patients without coronary inflammation were 10.2±1.6 mast cell /mm2 and 8.2±1.7 mast cell /mm2, respectively. The mast cell counts in the myocardium of patients with ECPA was slightly greater than that in patients without coronary inflammation. These differences in numbers of mast cells between patients with ECPA and patients without inflammation were considered to be influenced by coronary artery inflammation. The mast cell counts in the coronary adventitia of patients with ECPA was approximately 14 times greater than that in patients without coronary artery infection. These findings indicate that the adventitial resident mast cells of the coronary arteries in patients with ECPA might transform into a new phenotype with the ability to recruit eosinophils from the blood. Coronary spasm in patients with ECPA could be induced by mediators released from transformed mast cells and recruited eosinophils. However, the precise mechanism of mast cell transformation remains to be elucidated.

Citation:

Hiroki Kajihara, Mast Cell Density In The Heart Of Eosinophilic Coronary Periarteritis (ECPA): A Histochemical Study.Journal of Cardiovascular Diseases 2026.