[Clinicopathologic analysis of dilated heart in cardiac transplant recipients].
OBJECTIVE
To study the pathologic features of dilated heart in cardiac transplant recipients, with clinicoradiologic correlation.


METHODS
Sixty recipient hearts from cardiac transplantation performed in Fuwai Hospital were analyzed by gross examination, histologic observation and electron microscopy. Clinicoradiologic correlation was available in 40 cases.


RESULTS
Amongst the 40 cases of dilated heart, 52.5% (21/40) were due to dilated cardiomyopathy, 22.5% (9/40) due to arrhythmogenic right ventricular cardiomyopathy, 15.0% (6/40) due to ischemic cardiomyopathy, and the remaining 10.0% (4/40) due to miscellaneous causes, including local noncompaction of ventricular myocardium, giant cell myocarditis, alcoholic cardiomyopathy and hypertensive cardiomyopathy. The discrepancy rate between clinical and pathologic diagnosis was 37.5% (15/40). The erroneous categories included arrhythmogenic right ventricular cardiomyopathy (7 cases), ischemic cardiomyopathy (5 cases), and giant cell myocarditis (1 case), which were all mistaken clinically as dilated cardiomyopathy. While ischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, noncompaction of ventricular myocardium and giant cell myocarditis have distinctive pathologic features, the diagnosis of alcoholic and hypertensive cardiomyopathies required clinicopathologic correlation. Dilated cardiomyopathy due to viral myocarditis was not identified in the cases studied.


CONCLUSIONS
Pathologic examination is essential in analysis of transplant recipient heart and helps to rectify clinical diagnostic discrepancy.
Lü
Feng-Ying
FY
Department of Pathology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. lvfengyingxl@sina.com
Song
Lai-Feng
LF
Liu
Lei
L
Zhao
Hong
H
Wang
Hong-Yue
HY
Li
Li
L
Wang
Lin-Lin
LL
Wang
Qing-Zhi
QZ
Si
Wen-Xue
WX
Zhang
Lian-Zhuang
LZ
Li
Xiao-Hui
XH
Zhao
Ran-Xu
RX
D000293:Adolescent; D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis / Q000473:pathology; D002310:Cardiomyopathy, Alcoholic / Q000175:diagnosis / Q000473:pathology; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000473:pathology*; D003951:Diagnostic Errors; D004108:Dilatation, Pathologic / Q000175:diagnosis / Q000473:pathology; D005260:Female; D015726:Giant Cells / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000473:pathology; D009206:Myocardium / Q000473:pathology*