[Pathological characteristics of dilated hearts with sole myocardial wall damage in recipients].
OBJECTIVE
It is difficult to differentiate the causes of dilated cardiomyopathy only by clinical evaluation and image analysis. Pathomorphologic examinations on diseased hearts may help to improve the diagnosis accuracy.


METHODS
Fifty-six extransplanted hearts from June, 2004 to June, 2006 were examined. Gross and histopathological findings were recorded, photographed and final pathological diagnosis was compared to clinical diagnosis.


RESULTS
Dilations were caused by sole myocardial wall damage in 38 (67.9%) of the 56 patients, including 19 primary dilated cardiomyopathy, 9 arrhythmogenic right ventricular cardiomyopathy, 1 non-compaction cardiomyopathy, 6 ischemic cardiomyopathy, 1 alcoholic cardiomyopathy, 1 hypertensive cardiomyopathy and 1 giant cell myocarditis. The clinical and pathological diagnoses were different in 15 cases (39.5%). The most discrepancies were arrhythmogenic right ventricular cardiomyopathy (77.8%), ischemic cardiomyopathy (83.3%), and giant cell myocarditis (100%).


CONCLUSIONS
This pathological study of recipient hearts showed a high portion of patients with arrhythmogenic right ventricular cardiomyopathy and ischemic cardiomyopathy were misdiagnosed as primary cardiomyopathy. Correct diagnosis of primary cardiomyopathy needs to rule out possible secondary causes of myocardial dilation.
Zhao
Hong
H
Department of Pathology, Cardiovascular institute and Fu Wai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
Lü
Feng-ying
FY
Song
Lai-feng
LF
Wang
Hong-yue
HY
Li
Li
L
Liu
Lei
L
Chen
Guo-fen
GF
Huang
Jie
J
Hu
Sheng-shou
SS
D000293:Adolescent; D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000473:pathology; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000473:pathology; D009206:Myocardium / Q000473:pathology*; D055815:Young Adult