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- Title
Histopathological and clinical aspects in dilated cardiomyopathies.
- Authors
Tica, Ovidiu; Tica, Otilia-Anca; Rosca, Elena; Rosan, Larisa; Pantea, Vlad; Tor, Romina; Sandor, Mircea Ioan; Ignat-Romanul, Ioana; Hatos, Adrian; Popescu, Mircea-Ioachim
- Abstract
Introduction - Dilated cardiomyopathy (DCM) represents a group of myocardial disorders associated with mechanical and electrical dysfunctions that causes enlargement of both ventricles. Over 50% of primary DCM are familial in nature and the rest have genetic etiology. Secondary DCM may occur during a wide range of diseases. Functionally, DCM is characterized by systolic dysfunction leading finally to a diminished left ventricular ejection fraction. A good correlation has been found between the severity of the condition clinically and the extent and degree of microscopic abnormalities. Methods - The macroscopic features can be best appreciated with a four-chamber view of the heart or by the short axis (bread loafing) slicing technique. Myocardial fragments are harvested, trimmed and kept in fixation solution for minimum 24 hours necessary for microscopic examination. Subsequently, specimens undergoes tissue processing. Results - Gross examination reveals increased heart weight with a globular shape and a decreased tonus. Endocardial fibrous thickening starts over the septal portion of the LV where there is a prominent fine reticulation of trabecular muscles. At microscopic level, different degrees of myofibrillar hypertrophy (enlarged, irregularly shaped muscle fibers with hyperchromatic, squared off nuclei) and collagenous fibrosis are detected. Discussions - Familial DCM is proposed to be considered as a form of "cytoskeltopathy". Interstitial fibrosis contributes to ventricular dysfunction and affects prognosis in patients with DCM. Conclusions - Without cardio-pulmonary transplant, patients with DCM has ominous prognosis with greatly reduced 5-year survival. The most common histologic alteration in DCM patients is the onset of perivascular fibrosis and proliferation of collagen fibers.
- Subjects
DILATED cardiomyopathy; VENTRICULAR ejection fraction; HISTOPATHOLOGY
- Publication
Romanian Journal of Cardiology, 2018, Vol 28, Issue 1, p15
- ISSN
1220-658X
- Publication type
Article