[Morphologic changes in the valves in acquired heart defects]

The histologic, histochemical and ultrastructural changes of the leaflet tissue of all four cardiac valves obtained by biopsy and autopsy have been studied in 50 patients with acquired valvular defects. The anamnesis confirmed the presence of rheumatic fever in 16 patients and negated it in 34 patients. In all analysed leaflets of all four cardiac valves organic changes were found which were the cause of their dysfunction. The analysis has shown that rheumatic fever does not play a dominant role in development of acquired valvular disease as it has been thought previously. However, degenerative changes were most commonly found being of unknown etiology up to now. The morphological changes of valvular tissue in the patients suffering from rheumatic fever differ from those who did not suffer from it. Vascularization, fibrosis and hyalinization of the connective tissue with fibroelastic densities predominated in patients suffering from rheumatic fever while myxomatous degeneration of valvular tissue predominated in those who did not suffer from it. Different morphological parameters indicate the different etiopathogenesis of these diseases.