Cardiac muscle cell disorganization in apical hypertrophic cardiomyopathy: a cardiac biopsy study.
Apical hypertrophic cardiomyopathy has been divided into two entities: apical asymmetric septal hypertrophy (apical ASH) and apical symmetric hypertrophy (AH). The latter differs clinically from hypertrophic cardiomyopathy (HCM) with ASH, and it is unclear whether AH represents a distinct subtype of HCM. In the present study, the presence or absence and the extent of cardiac muscle cell disorganization, a histologic characteristic of HCM, were compared in patients with AH (n = 10) and ASH (n = 29) in whom cardiac biopsy specimens were obtained from the left ventricular apex and interventricular septum. Disorganization was graded as (1+) in only 1 patient in the AH group and (-) in the remaining 9. In contrast, in the ASH group disorganization was graded as (1+) in 15 patients, (2+) in 7, (3+) in 3, and (-) in only 4 (P < 0.0001). Thus, it was observed that in AH disorganization is virtually absent or at most limited to a very narrow area. It is concluded from a histological stand point as well that the type of apical hypertrophic cardiomyopathy showing apical symmetric hypertrophy differs from usual HCM.
Morimoto
Shin-ichiro
S
Division of Cardiology, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Sekiguchi
Morie
M
Uemura
Akihisa
A
Hiramitsu
Shinya
S
Kimura
Katsutomo
K
Ohtsuki
Masatsugu
M
Ishii
Junichi
J
Kato
Shigeru
S
Kasanuki
Hiroshi
H
Hishida
Hitoshi
H
D001706:Biopsy; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology*; D004452:Echocardiography; D004562:Electrocardiography; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009206:Myocardium / Q000473:pathology*; D032383:Myocytes, Cardiac / Q000473:pathology*