[Changes in the contractile myocardium in chronic ischemic heart disease]

Myocardial biopsies from 16 patients who underwent the operation of aorto-coronary shunt in connection with coronary arteries stenosis are examined. It is shown that in the myocardium of these patients, along with the compensatory-adaptive processes (firstly myocardial hyperthrophy resulting from intracellular structures hyperplasia) morphological signs of the exhaustion of plastic and regenerative capacities of the heart are pronounced. The following morphological features apparently characterizing the development of myocardial hyperthrophy as a result of long-lasting and progressive disease are observed: (1) formation of multicomponental muscular fibers consisting of a group of cardiomyocytes (CMC) connected by intercalated discs localised between their lateral surfaces and remaining hypertrophied even when atrophy of some CMC occurs; (2) longitudinal and thansversal myofibril dissociation. The results obtained allow the authors to understand to some extent the clinical course of chronic ischemic heart disease in this category of patients.