[Structural and adaptational insufficiency of the myocardium and its quantitative analysis]

A concept of the pathogenesis of cardiac insufficiency explaining the decompensation mechanism from the point of view of premature realization of genetically determined program of age adaptation of cardiomyocytes materially based on linear increase of the volumetrical density of mitochondria is suggested. The etiological factors accelerating the time course of this process produce the effect of premature "ageing" of muscle cells and decrease of the contractile capacity of the myocardium and its adaptation abilities inadequate for the age requirements. A quantitative measure of the adaptation reserve is the difference between the maximum (40%) and actual, that is, altered, volumetric density of mitochondria the value of which may be established by myocardial biopsy. The degree of decompensation is determined by the difference between the actual and age (definite for each age) value of this parameter, the possibility of correction of this process being inversely proportional to this value.