Document Detail

Lipomatous metaplasia in left ventricular scar.
MedLine Citation:
PMID:  9039067     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Substitution of interstitial tissue by fat may be observed in the right ventricle of hearts but is less common in the left ventricle. Fat was noted in myocardial scars of patients undergoing heart transplantation, prompting this retrospective study to determine the frequency of left ventricular myocardial scar being replaced by fat and its significance METHODS AND RESULTS: The left and right ventricles and coronary arteries were sampled systematically and lesions quantified histologically in 97 normal subjects dying accidentally; 116 consecutive failing hearts excised at transplantation from patients with ischemic heart disease, idiopathic dilated cardiomyopathy or chronic valvulopathy; and 34 autopsy hearts of apparently normal subjects with "silent' Chagas' heart disease who died suddenly and unexpectedly. Twenty-two left ventricular aneurysmectomy specimens from ischemic patients with heart failure were also studied. Among excised hearts lipomatous metaplasia of myocardial scar was observed in 68% of ischemic heart disease, in 37% of chronic valvulopathy and in 26% of idiopathic dilated cardiomyopathy patients; it was seen in 15% of Chagasic patients and in 55% of aneurysm walls. CONCLUSIONS: Lipomatous metaplasia of scar is often associated with severe heart failure and is more frequent and extensive in ischemic heart disease. Transformation of a compact scar into compressible and "sliding' adipose tissue may worsen ventricular wall function, thus facilitating and/or aggravating aneurysm formation. This phenomenon must be considered in the evaluation of myocardial repair, cardiac imaging of viable myocardium, quantitative morphology of autopsy specimens, and qualitative and quantitative biochemical analysis of myocardial tissue.
G Baroldi; M D Silver; R De Maria; O Parodi; A Pellegrini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  13     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-03-07     Completed Date:  1997-03-07     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  65-71     Citation Subset:  IM    
Institute of Clinical Physiology, National Research Council (CNR), Department of Cardiology De Gasperis, Milan, Italy.
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MeSH Terms
Adipose Tissue / pathology*
Aged, 80 and over
Cardiomyopathy, Dilated / complications
Chagas Disease / pathology
Cicatrix / pathology*
Coronary Aneurysm / pathology,  surgery
Heart Failure / etiology,  pathology*
Heart Transplantation
Heart Valve Diseases / complications
Heart Ventricles / pathology*
Linear Models
Middle Aged
Myocardial Ischemia / complications
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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