Ultrastructural morphometric findings of cardiomyocytes in patients with impaired ventricular function — a comparative clinicopathological study

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• 作者：Katharina Wassilew^a ; ^{wassilew@dhzb.de" class="auth_mail" title="E-mail the corresponding author} ; Denis Terziev^b ; Georgi Wassilew^c ; Gü ; nther Fitzl^b ; Karsten Frö ; lich^d ; Reinhard Kandolf^e ; Andreas Fried^f
• 关键词：HF ; heart failure ; NYHA ; New York Heart Association ; EMB ; endomyocardial biopsy ; Pt ; patient ; DCM ; dilated cardiomyopathy ; PT ; grid with cut points ; a ; grid constant ; m ; mitochondria ; myo ; myofibrils ; z ; z-lines ; cr ; mitochondrial cristae ; Pi ; points of relevant subcellular structures ; Ci ; cut points of relevant subcellular structures ; Ni ; number of relevant subcellular structures ; Vvi ; volume density (Pi/PT) ; Svi ; surface density=2Ci/(PT*a) ; Nai ; numerical density=[Ni/(PT*a2)] ; Sv/Vv ; surface t
• 刊名：Cardiovascular Pathology
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：25
• 期：1
• 页码：25-32
• 全文大小：1360 K

文摘

The present study aims to analyze the differences in ultrastructural changes between right ventricular myocardium in clinically determined grades of heart failure (HF) [New York Heart Association (NYHA) classes I–IV] and their value in the routine diagnostic setting.

Methods

We investigated consecutive right ventricular endomyocardial biopsies of 12 patients presenting with HF (49±11.2 years; male=10) by light microscopy and ultrastructural morphometric analysis. The patients were divided into four groups according to their NYHA classes (NYHA I: n= 1, II: n= 2, III: n= 8, IV: n= 1). We used a stereological point counting method on electron micrographs to determine the volume, surface, and numerical density of cardiomyocyte myofibrils; z-lines; mitochondria; and cristae as required. Further, secondary parameters were calculated.

Results

Myofibrillar parameters increased between NYHA class I and II (P< .01), which matched with more pronounced cardiomyocyte hypertrophy on the light microscopic level. In NYHA classes III and IV, the myofibrillar parameters dropped, while parameters concerning the mitochondria and their cristae rose (P< .01). This resulted in an elevated mitochondria to myofibril ratio (P< .05) and correlated with histologically evident atrophic cardiomyocytes, perinuclear loss of myofibrils and dot-like perinuclear staining positive on peroxide acid shift.

Conclusion

In this present study, right ventricular myocardial ultrastructure differed between patients diagnosed with HF of different degrees in distinct subcellular changes. These findings suggest that ultrastructural analysis, while correlated with histopathological features, adds to the diagnosis in the routine diagnostic setting, specifically in lower NYHA grades, in which only minor changes are observed histologically.