| Hypertrophic cardiomyopathy: the interrelation of disarray, fibrosis, and small vessel disease. | |
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MedLine Citation:
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PMID: 11040002 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To make a quantitative assessment of the relation between disarray, fibrosis, and small vessel disease in hypertrophic cardiomyopathy. DESIGN: Detailed macroscopic and histological examination at 19 segments of the left and right ventricle and the left atrial free wall. PATIENTS: 72 patients with hypertrophic cardiomyopathy who had suffered sudden death or progression to end stage cardiac failure (resulting in death or heart transplantation). MAIN OUTCOME MEASURES: The presence of scarring, atrial dilatation, and a mitral valve impact lesion were noted, and heart weight, wall thickness, per cent disarray, per cent fibrosis, and per cent small vessel disease quantitated for each heart. RESULTS: Within an individual heart the magnitude of hypertrophy correlated with the severity of fibrosis (p = 0.006) and disarray (p = 0.0002). Overall, however, total heart weight related weakly but significantly to fibrosis (r = 0.4, p = 0.0001) and small vessel disease (r = 0.3, p = 0.03), but not to disarray. Disarray was greater in hearts with mild left ventricular hypertrophy (maximum wall thickness < 20 mm) and preserved systolic function (60.9 (26)% v 43 (20.4)% respectively, p = 0.02) and hearts without a mitral valve impact lesion (26.3% v 18.9%, p = 0.04), but was uninfluenced by sex. Fibrosis was influenced by sex (7% in male patients and 4% in female, p = 0.04), but not by the presence of an impact lesion. No relation was found between disarray, fibrosis, and small vessel disease. CONCLUSIONS: Myocyte disarray is probably a direct response to functional or structural abnormalities of the mutated sarcomeric protein, while fibrosis and small vessel disease are secondary phenomena unrelated to disarray, but modified by factors such as left ventricular mass, sex, and perhaps local autocrine factors. |
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Authors:
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A M Varnava; P M Elliott; S Sharma; W J McKenna; M J Davies |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 84 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2000 Nov |
Date Detail:
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Created Date: 2000-11-09 Completed Date: 2000-11-09 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 476-82 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Pathology, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. avarnava@sghms.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Cardiomyopathy, Hypertrophic / pathology* Child Coronary Disease / pathology* Dilatation, Pathologic Female Fibrosis Heart Atria / pathology Humans Hypertrophy, Left Ventricular / pathology Male Middle Aged Mitral Valve / pathology Myocardium / pathology Organ Size |
| Comments/Corrections | |
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