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Histological and morphometric analysis of dilated cardiomyopathy with special reference to collagen IV expression

Parul Jain1, Sudheer Arava1, Sandeep Seth2

  • 1Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Indian Journal of Pathology & Microbiology
|January 12, 2018
PubMed

Insights

Dilated cardiomyopathy shows non-specific histomorphological changes. Histological parameters do not predict disease progression, as they lack correlation with left ventricular ejection fraction (LVEF).

Area of Science:

  • Cardiovascular Pathology
  • Cardiac Histomorphology
  • Extracellular Matrix Research

Background:

  • Dilated cardiomyopathy (DCM) is characterized by known alterations in collagen distribution and microvasculature.
  • Histomorphological changes, including microvascular and extracellular matrix modifications, are observed in DCM.

Purpose of the Study:

  • To investigate the histomorphological features of DCM.
  • To quantitatively correlate these features with left ventricular ejection fraction (LVEF).
  • To evaluate alterations in collagen IV distribution and microvasculature in DCM.

Main Methods:

  • Analysis of 34 DCM endomyocardial biopsies, 7 explanted hearts, and 41 control hearts.
  • Histological staining (H&E, Masson trichrome) and immunohistochemistry (CD34, SMA, Collagen IV).
  • Morphometric analysis using Image pro plus 7 software, correlated with LVEF.

Main Results:

  • DCM exhibits myocyte hypertrophy, nucleomegaly, interstitial fibrosis, myocarditis, and vessel wall changes.
  • Significant increase in nuclear area, myocyte width, and fibrosis percentage; reduced capillary-myocyte ratio.
  • Marked alteration in Collagen IV distribution with reduced staining intensity around myocytes.

Conclusions:

  • Histomorphological changes in DCM are non-specific.
  • Histological parameters do not predict disease progression due to lack of correlation with LVEF.
  • Significant alterations in Collagen IV distribution indicate extracellular matrix remodeling in DCM.
Abstract

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