Alterations of the vessel wall innervation during diabetes mellitus.

Coronary and valvular heart disease during diabetes mellitus (DM) are major contributors of morbidity and mortality in the diabetic population. Relatively little atention has been given to the study of heart valve nerve structures in different pathological processes. In this study we have demonstrated the presence of possible morphological alterations in vessels of the anterior cusp of the rat mitral valve during 8-12 weeks DM. A histochemical method was used for the detection of NADPH-diaphorase (NADPH-d), which is the indirect NO-synthase marker. Arterioles and fine capillaries were localized in the attachment zone of the anterior cusp. Perivascular nerve fibres were identified running in the tunica adventitia. A marked dilatation of the vessels was seen in diabetes in comparison with control samples. No NADPH-d positive nerve fibres were observed in the tunica adventitia. It can be presumed that metabolic changes in the vessel walls during DM reflect modified neurotransmission of NO by means of their excessive overproduction of NOS (endothelial--eNOS) in endothelial cells. (Fig. 6, Ref. 32.).