Circulation, Vol 89, 151-163, Copyright © 1994 by American Heart Association
CA Beltrami, N Finato, M Rocco, GA Feruglio, C Puricelli, E Cigola, F Quaini, EH Sonnenblick, G Olivetti and P Anversa
BACKGROUND: Ischemic cardiomyopathy is characterized by myocyte loss,
reactive cellular hypertrophy, and ventricular scarring. However, the
relative contribution of these tissue and cellular processes to late
failure remains to be determined. METHODS AND RESULTS: Ten hearts were
obtained from individuals undergoing cardiac transplantation as a result of
chronic coronary artery disease in its terminal stage. An identical number
of control hearts were collected at autopsy from patients who died from
causes other than cardiovascular disease, and morphometric methodologies
were applied to the analysis of the left and right ventricular myocardium.
Left ventricular hypertrophy evaluated as a change in organ weight,
aggregate myocyte mass, and myocyte cell volume per nucleus showed
increases of 85%, 47%, and 103%, respectively. Corresponding increases in
the right ventricle were 75%, 74%, and 112%. Myocyte loss, which accounted
for 28% and 30% in the left and right ventricles, was responsible for the
difference in the assessment of myocyte hypertrophy at the ventricular,
tissue, and cellular levels. Left ventricular muscle cell hypertrophy was
accomplished through a 16% and 51% increase in myocyte diameter and length,
whereas right ventricular myocyte hypertrophy was the consequence of a 13%
and 67% increase in these linear dimensions, respectively. Moreover, a 36%
reduction in the number of myocytes included in the thickness of the left
ventricular wall was found. Collagen accumulation in the form of segmental,
replacement, and interstitial fibrosis comprised an average 28% and 13% of
the left and right ventricular myocardia, respectively. The combination of
cell loss and myocardial fibrosis, myocyte lengthening, and mural slippage
of cells resulted in 4.6-fold expansion of left ventricular cavitary volume
and a 56% reduction in the ventricular mass-to-chamber volume ratio.
CONCLUSIONS: These results are consistent with the contention that both
myocyte and collagen compartments participate in the development of
decompensated eccentric ventricular hypertrophy in the cardiomyopathic
heart of ischemic origin.
ARTICLES
Structural basis of end-stage failure in ischemic cardiomyopathy in humans
Department of Pathology, University of Udine, Italy.
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H. F. Clemo, B. S. Stambler, and C. M. Baumgarten Persistent Activation of a Swelling-Activated Cation Current in Ventricular Myocytes From Dogs With Tachycardia-Induced Congestive Heart Failure Circ. Res., July 27, 1998; 83(2): 147 - 157. [Abstract] [Full Text] [PDF] |
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J. Kajstura, A. Leri, N. Finato, C. Di Loreto, C. A. Beltrami, and P. Anversa Myocyte proliferation in end-stage cardiac failure in humans PNAS, July 21, 1998; 95(15): 8801 - 8805. [Abstract] [Full Text] [PDF] |
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K. T. Weber Extracellular Matrix Remodeling in Heart Failure : A Role for De Novo Angiotensin II Generation Circulation, December 2, 1997; 96(11): 4065 - 4082. [Full Text] |
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K. McDonald, C. Chu, G. Francis, D. Judd, W. Carlyle, C. Toher, K. Hauer, and M. Hartman The effect of delayed reperfusion following infarction in the rat on structural changes in viable myocardium Cardiovasc Res, December 1, 1997; 36(3): 347 - 353. [Abstract] [Full Text] [PDF] |
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E. Missov, C. Calzolari, and B. Pau Circulating Cardiac Troponin I in Severe Congestive Heart Failure Circulation, November 4, 1997; 96(9): 2953 - 2958. [Abstract] [Full Text] |
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B. Li, Q. Li, X. Wang, K. P. Jana, G. Redaelli, J. Kajstura, and P. Anversa Coronary constriction impairs cardiac function and induces myocardial damage and ventricular remodeling in mice Am J Physiol Heart Circ Physiol, November 1, 1997; 273(5): H2508 - H2519. [Abstract] [Full Text] [PDF] |
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G. Olivetti, R. Abbi, F. Quaini, J. Kajstura, W. Cheng, J. A. Nitahara, E. Quaini, C. Di Loreto, C. A. Beltrami, S. Krajewski, et al. Apoptosis in the Failing Human Heart N. Engl. J. Med., April 17, 1997; 336(16): 1131 - 1141. [Abstract] [Full Text] [PDF] |
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B. I. Jugdutt, M. J. Joljart, and M. I. Khan Rate of Collagen Deposition During Healing and Ventricular Remodeling After Myocardial Infarction in Rat and Dog Models Circulation, July 1, 1996; 94(1): 94 - 101. [Abstract] [Full Text] |
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C.M. Yu, J.E. Sanderson, S. Chan, L. Yeung, Y.T. Hung, and K.S. Woo Right Ventricular Diastolic Dysfunction in Heart Failure Circulation, April 15, 1996; 93(8): 1509 - 1514. [Abstract] [Full Text] |
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D. Darbar, J. Luck, N. Davidson, T. Pringle, G. Main, G. McNeill, and A. D Struthers Sensitivity and specificity of QTc dispersion for identification of risk of cardiac death in patients with peripheral vascular disease BMJ, April 6, 1996; 312(7035): 874 - 878. [Abstract] [Full Text] |
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C.H. Davies, K. Davia, J.G. Bennett, J.R. Pepper, P.A. Poole-Wilson, and S.E. Harding Reduced Contraction and Altered Frequency Response of Isolated Ventricular Myocytes From Patients With Heart Failure Circulation, November 1, 1995; 92(9): 2540 - 2549. [Abstract] [Full Text] |
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J. Kajstura, X. Zhang, Y. Liu, E. Szoke, W. Cheng, G. Olivetti, T. H. Hintze, and P. Anversa The Cellular Basis of Pacing-Induced Dilated Cardiomyopathy : Myocyte Cell Loss and Myocyte Cellular Reactive Hypertrophy Circulation, October 15, 1995; 92(8): 2306 - 2317. [Abstract] [Full Text] |
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K. M. McDonald, J. Mock, A. D'Aloia, T. Parrish, K. Hauer, G. Francis, A. Stillman, and J. N. Cohn Bradykinin Antagonism Inhibits the Antigrowth Effect of Converting Enzyme Inhibition in the Dog Myocardium After Discrete Transmural Myocardial Necrosis Circulation, April 1, 1995; 91(7): 2043 - 2048. [Abstract] [Full Text] |
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D. Orlic, J. Kajstura, S. Chimenti, F. Limana, I. Jakoniuk, F. Quaini, B. Nadal-Ginard, D. M. Bodine, A. Leri, and P. Anversa Mobilized bone marrow cells repair the infarcted heart, improving function and survival PNAS, August 28, 2001; 98(18): 10344 - 10349. [Abstract] [Full Text] [PDF] |
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J. A. Fallavollita and J. M. Canty Jr. Ischemic cardiomyopathy in pigs with two-vessel occlusion and viable, chronically dysfunctional myocardium Am J Physiol Heart Circ Physiol, April 1, 2002; 282(4): H1370 - H1379. [Abstract] [Full Text] [PDF] |
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Y. Takimoto, T. Aoyama, Y. Iwanaga, T. Izumi, Y. Kihara, D. Pennica, and S. Sasayama Increased expression of cardiotrophin-1 during ventricular remodeling in hypertensive rats Am J Physiol Heart Circ Physiol, March 1, 2002; 282(3): H896 - H901. [Abstract] [Full Text] [PDF] |
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