title: Histopathological study of specimens obtained by left ventricular biopsy during ventriculoplasty for idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  Pathological changes in the myocardium in idiopathic dilated cardiomyopathy (DCM) are usually studied using endomyocardial biopsy specimens, but the relationship between pathological changes in the myocardium and clinical findings is unclear. The goal of the study was to examine correlations between clinical findings and histopathological findings in specimens of the left ventricular myocardium collected during left ventriculoplasty in DCM patients.
  
  
  METHODS
  The subjects were 20 DCM patients (17 males and 3 females; mean age: 59 ± 14 years old) who underwent left ventriculoplasty, including 16 cases of overlapping ventriculoplasty (OLVP) and 4 of papillary muscle approximation (PMA) with left ventricular incision. Preoperative age, sex, The New York Heart Association (NYHA) classification, the brain natriuretic peptide (BNP) level, cardiothoracic ratio (CTR), echocardiographic data, history of diabetes mellitus, drug history of spironolactone, ACE inhibitor, ARB, and β-blocker were used as clinical findings. Histopathological scores were determined for each patient and semi-quantitative data for hypertrophy, attenuation, vacuolation and fibrosis were obtained.
  
  
  RESULTS
  A significant correlation was found between age and interstitial fibrosis. A significant inverse correlation was found between left ventricular diastolic diameter (LVDd) in echocardiographic data and interstitial fibrosis. There were no other significant relation between histopathological scores and clinical findings.
  
  
  CONCLUSIONS
  From this study, we found that interstitial fibrous increased with aging and more dilated LVDd had less interstitial fibrosis. It is concluded that the kinetics of myocardial fibrosis with remodeling might be variable and histopathological findings does not reflect the clinical and hemodynamic changes in DCM patients. Further morphological data are needed to verify this result.
authors.affiliation: Department of Cardiovascular Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. shimura@is.icc.u-tokai.ac.jp
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shimura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
authors.forename: Chikao
authors.initials: C
authors.lastname: Yutani
authors.forename: Yukio
authors.initials: Y
authors.lastname: Suto
authors.forename: Okihiko
authors.initials: O
authors.lastname: Akashi
authors.forename: Kinya
authors.initials: K
authors.lastname: Matsui
authors.forename: Yasushige
authors.initials: Y
authors.lastname: Shingu
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Haruki
authors.forename: Kou
authors.initials: K
authors.lastname: Takigami
authors.forename: Takashi
authors.initials: T
authors.lastname: Minase
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ueda
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000473:pathology* / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005355:Fibrosis; D006352:Heart Ventricles / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000378:metabolism
chemical_list: D020097:Natriuretic Peptide, Brain