Myocardial structure and left ventricular function in hypertrophic and dilative cardiomyopathy and aortic valve disease.
Left ventricular biopsies from 126 patients with advanced (EF less than 50%, n = 45) and mild (EF 50-60%, n = 21) and latent cardiomyopathy (EF greater than 60%, n = 60) and 18 additional patients with aortic valve disease and 22 cases with hypertrophic cardiomyopathy were analyzed to define possible correlations between myocardial structure and function. Deterioration of ventricular function was combined with increasing muscle cell diameters (r = 0.47) and increasing nuclear size of the myocytes (r = 0.74) in latent and dilative cardiomyopathies and in patients with aortic valve disease (cell diameter, r = 0.6; nuclear size, r = 0.9). Patients with HCM showed a wide range of cell diameter and nuclear size. 24% of the latter patients had no bioptic evidence of myocardial hypertrophy. The mitochondrial volume of the myocytes was 23% in the normal and hypertrophied myocardium independent of the kind of disease and ventricular function. The volume fraction of the myofibrils continuously decreased with worsening of the left ventricular function in patients with latent and dilative cardiomyopathy (from 45 +/- 6.9 to 37.6 +/- 6.3%) and aortic valve disease (from 46.2 +/- 3.4 to 27.9 +/- 9.3%). Patients with hypertrophic cardiomyopathy presented with normal or slightly decreased values of myofibrils consistent with normal ventricular function (42.5 +/- 5.0). The data demonstrate that the degree of myocardial hypertrophy and certain ultrastructural findings are inversely correlated with left ventricular function.
Medizinische Poliklinik der Universität Erlangen, F.R.G.
B
B
Kunkel
M
M
Schneider
D001021:Aortic Valve; D002311:Cardiomyopathy, Dilated / Q000473:pathology* / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000473:pathology* / Q000503:physiopathology; D006321:Heart / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D009210:Myofibrils / Q000473:pathology; D013318:Stroke Volume