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Relation between myocyte disarray and outcome in hypertrophic cardiomyopathy
A M Varnava1, P M Elliott, N Mahon
1Department of Cardiovascular Pathology and Cardiological Sciences, St George's Hospital Medical School, London, United Kingdom. avarnava@sghms.ac.uk
The American Journal of Cardiology
|July 27, 2001
Summary
Hypertrophic cardiomyopathy (HC) patients with greater myocyte disarray, especially younger individuals, face higher risks. Myocardial fibrosis is linked to heart failure deaths and ventricular arrhythmias in HC patients.
Area of Science:
- Cardiology
- Pathology
- Genetics
Background:
- Hypertrophic cardiomyopathy (HC) increases risks of sudden cardiac death and heart failure.
- The pathological basis for premature death in HC remains poorly understood.
Purpose of the Study:
- To correlate pathological findings in hypertrophic cardiomyopathy with the mode of death and patient risk profiles.
Main Methods:
- Examined 75 hearts from deceased or transplanted HC patients.
- Correlated clinical data with macroscopic findings, myocyte disarray, fibrosis, and small-vessel disease across 19 heart sections.
Main Results:
- Myocyte disarray correlated with ischemia and was higher in patients dying before age 21 and those with abnormal exercise vascular response.
- Myocardial fibrosis was greater in patients who died from heart failure and those with nonsustained ventricular tachycardia or high-risk fractionation study results.
Conclusions:
- Younger HC patients exhibit greater myocyte disarray.
- Myocardial fibrosis is the pathological substrate for heart failure deaths and ventricular arrhythmias in hypertrophic cardiomyopathy.
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