By Rossella Lorenzi
The oldest case of acute decompensated heart failure has been found
in 3,500-year-old mummified remains, a research team announced at the
international congress of Egyptology in Florence.
Consisting of just a head and canopic jars containing internal
organs, the remains were found in a plundered tomb by the Italian
Egyptologist Ernesto Schiaparelli in 1904 in the Valley of the Queens,
Luxor, and are now housed at the Egyptian Museum in Turin.
They belong to an Egyptian dignitary named Nebiri, a “Chief of
Stables” who lived under the reign of 18th Dynasty pharaoh Thutmoses III
“The head is almost completely unwrapped, but in a good state of
preservation. Since the canopic jar inscribed for Hapy, the guardian of
the lungs, is partially broken, we were allowed direct access for
sampling,” Raffaella Bianucci, an anthropologist in the legal medicine
section at the University of Turin, told Discovery News.
She investigated the mummified remains with researchers from the Universities of Turin, Munich and York.
Detailing the findings at the conference, Bianucci reported
that Nebiri was middle aged — 45 to 60 years old — when he died and that
he was affected by a severe periodontal disease with massive abscesses,
as revealed by Multidetector Computed Tomography (MDCT) and three
dimensional skull reconstruction.
The scans showed there was a partial attempt at excerebration
(removal of the brain), but a considerable amount of dehydrated brain
tissue is still preserved. Linen is packed in the inner skull, eyes,
nose, ears, mouth and even fill the cheeks.
The researchers also detected evidence of calcification in the right
internal carotid artery, consistent with a mild atherosclerosis.
“We saw only a tiny fleck of calcium. Since the rest of the
corpse is missing, it is impossible to establish whether there was
calcification in other artery walls,” she added.
Most interestingly, the histology of the lung performed by
Andreas Nerlich, professor at the department of pathology at
Ludwig-Maximilians-University in Munich, Germany, revealed the presence
of “heart failure” cells. A pulmonary edema, which is fluid accumulation
in the lungs’s air sacs, was also identified.
“When the heart is not able to pump efficiently, blood can back
up into the veins that take it through the lungs. As the pressure
increases, fluid is pushed into the air spaces in the lungs,” Bianucci
Since histochemical staining ruled out other possible diseases
including tuberculosis, granulomas and acid-fast bacilli indicating
mycobacterial infections, the researchers concluded that Nebiri possibly
died from acute decompensation of chronic left-sided heart failure,
which is a frequent consequence of chronic heart disease.
“Our finding represents the oldest evidence for chronic heart failure in mummified remains,” Bianucci said.
Valvular disease, ischemia, metabolic disorders of the heart muscle,
or chronic hypertension are among the causes for the disorder.
In Nebiri’s case, the researchers believe chronic hypertension is the best candidate.
Currently, over 20 million people worldwide, mainly over 65, are affected by chronic heart failure.
“A systematic analysis of canopic jar content could help establish
whether the disease was more frequent in our ancestors or its prevalence
increased in modern times,” Bianucci said.
The elaborate mummification technique played a crucial role in diagnosing the cause of death, according to the researchers.
“The level of preservation is outstanding and easily equals the
standard seen with royals of the time,” Egyptologist Joann Fletcher,
professor at the University of York’s Department of Archaeology, told
Chemical analysis of the compounds used to treat Nebiri’s corpse revealed a relatively high quality of mummification.
“It was a complex mixture of an animal fat or plant oil, a
balsam/aromatic plant, and non-native conifer resin and pistacia resin.
The last three ingredients contain strongly antibacterial compounds, so
would certainly have helped preserve his body and lungs,” Stephen
Buckley, an archaeological chemist at the University of York in England,
told Discovery News.
Current research is now focusing on Nebiri’s facial
reconstruction, which is being carried out by Tobias Houlton and
Christopher Rynn from the University of Dundee, UK.