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Structural remodeling of cardiac myocytes in patients with ischemic cardiomyopathy

A M Gerdes1, S E Kellerman, J A Moore

  • 1Department of Anatomy, University of South Florida, College of Medicine, Tampa 33612.

Circulation
|August 1, 1992
PubMed

Insights

In ischemic cardiomyopathy (ICM), heart chamber dilation is primarily caused by cardiac myocytes increasing in length, not slippage. This change in myocyte shape contributes to increased heart wall stress.

Area of Science:

  • Cardiovascular Biology
  • Cardiac Remodeling
  • Heart Failure Pathophysiology

Background:

  • Chronic ischemic heart disease can cause ventricular dilation and congestive heart failure, a condition known as ischemic cardiomyopathy (ICM).
  • The specific alterations in cardiac myocyte shape contributing to this ventricular dilation in ICM have not been previously understood.

Purpose of the Study:

  • To investigate the changes in cardiac myocyte dimensions and shape within the context of ischemic cardiomyopathy.
  • To determine whether intracellular changes (myocyte lengthening) or extracellular changes (myocyte slippage) are responsible for chamber dilation in ICM.

Main Methods:

  • Isolated left ventricular myocytes were obtained from explanted human hearts of patients with ICM and from nonfailing donor hearts with normal coronary arteries (NCA).
  • Myocyte dimensions, including length and width, were quantitatively assessed and compared between the ICM and NCA groups.

Main Results:

  • Myocytes from ICM hearts were significantly longer (40% increase) and had a greater length/width ratio (49% increase) compared to myocytes from NCA hearts.
  • No significant difference was observed in myocyte width or sarcomere length between the two groups.
  • The observed increase in myocyte length closely mirrors the documented increase in end-diastolic diameter in patients with ICM.

Conclusions:

  • Increased myocyte length, an intracellular alteration, is the primary driver of chamber dilation in ischemic cardiomyopathy.
  • Maladaptive remodeling of myocyte shape, specifically increased length-to-width ratio, may exacerbate elevated cardiac wall stress in ICM.
Abstract

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