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Pathomorphological variants of midventricular obstruction of interventricular septum during hypertrophic

V D Rozenberg1, L M Nepomnyashchikh

  • 1Department of General Pathology and Pathomorphology, Institute of Regional Pathology and Pathomorphology, Siberian Division of the Russian Academy of Medical Sciences, Novosibirsk, Russia.

Bulletin of Experimental Biology and Medicine
|September 30, 2004
PubMed

Insights

Hypertrophic cardiomyopathy involves diverse interventricular septum thickening patterns, impacting cardiac hemodynamics. These geometric changes explain discrepancies between echocardiographic and pathomorphological findings in hypertrophic cardiomyopathy.

Area of Science:

  • Cardiology
  • Pathology
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) is a significant cause of cardiac morbidity and mortality.
  • Understanding the diverse structural changes in HCM is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the specific variants and forms of interventricular septum hypertrophy in patients with hypertrophic cardiomyopathy.
  • To correlate geometrical structural changes with intracardiac hemodynamics and diagnostic data.

Main Methods:

  • Postmortem cardiac ventriculography, coronarography, and cardiometry were utilized.
  • Echocardiography and pathomorphological data correlation techniques were employed.
  • Examination of 100 hearts from patients deceased from hypertrophic cardiomyopathy.

Main Results:

  • Identified distinct variants of midventricular hypertrophy, including midleft ventricular, midright ventricular, midproximal, and midmaximal obstruction.
  • Documented isolated distal apex and apical hypertrophy.
  • Observed multiplanar variability and mobility of the interventricular septum with a catenary shape.

Conclusions:

  • Specific geometric alterations in the septum and left ventricle define various hypertrophic cardiomyopathy phenotypes.
  • Interventricular septum characteristics contribute to abnormal intracardiac hemodynamics.
  • These factors explain diagnostic discrepancies and are key to understanding hypertrophic cardiomyopathy pathogenesis and outcomes.

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