[Immunohistologic findings in patients with myocardial hypertrophy]

Heart reactive antibodies have been found with direct and indirect immunofluorescence in patients with congestive cardiomyopathy. The authors therefore investigated by direct immunofluorescence 25 patients with aortic valve disease and 11 patients with congestive cardiomyopathy who underwent diagnostic heart catheterization and left ventricular endomyocardial biopsy. The left ventricular biopsies were fixed by bouin, formaline and freeze-drying. A first analysis was performed to determine auto- or formaline-induced fluorescence. A second analysis was performed to identify myocardial structures with positive fluorescence using 5 different anti-sera or patient's serum. The results showed positive fluorescence with anti-IgG-antibodies in patients with aortic valve disease (23%) and with congestive cardiomyopathy (73%). The immunoglobulin deposits were located mainly in the subendocardial connective tissue. These deposits showed also slight fluorescence with anti-IgM, anti-C1q and anti-C4 antibodies. However, a correlation between the hemodynamic and immunologic findings was not demonstrated. It is concluded that the myocardial immune complexes appear to be reactive and do not play an essential role in the pathogenesis of congestive cardiomyopathy.