Circulation, Vol 63, 1289-1298, Copyright © 1981 by American Heart Association
U Baandrup, RA Florio, F Roters and EG Olsen
Electron microscopic and statistical analyses of 66 right ventricular
biopsies from 48 patients were undertaken to investigate whether
quantitative differences exist between those patients with "ordinary"
myocardial hypertrophy and those suffering from a form of cardiomyopathy.
The electron microscopic changes were scored and correlated with
hemodynamic variables such as ejection fraction (EF), left ventricular
end-diastolic pressure (LVEDP) and length of history. The patients were
followed for an average of 22.5 months, permitting an assessment of
prognosis. The results show that the three diagnostic groups--"ordinary"
hypertrophy, hypertrophic cardiomyopathy (HOCM) and congestive
cardiomyopathy (COCM)--overlap, but crossover of sarcomeres is more
frequent in patients in whom HOCM is diagnosed. Except for a tenuous
relationship between EF, and the electron microscopy (EM) (r = - 0.46, p
less than 0.1) and between LVEDP and EM score (r = 0.61, p less than 0.01),
in the COCM group, no correlation could be established between EF, LVEDP
and length of history when the patients were grouped according to
histologic or clinical diagnosis. This study shows that the various claims
regarding relationships between morphologic changes and the functional
status of patients or prognosis cannot be confirmed.
ARTICLES
Electron microscopic investigation of endomyocardial biopsy samples in hypertrophy and cardiomyopathy. A semiquantitative study in 48 patients
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