Autopsy of a 68-year-old woman with hypertrophic cardiomyopathy revealed extensive myocardial fibrosis and significant lymphocytic infiltration with a CD4 to CD8 ratio of 3.8, suggesting an undefined inflammatory process.
Case Report (n=1)
No
This case report suggests that an undefined inflammatory process, characterized by CD4-predominant lymphocytic infiltration, may contribute to myocardial fibrosis in hypertrophic cardiomyopathy.
Myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM) may play an important role in the function and/or dimensions of the left ventricle. We present an autopsied case of HCM followed for 10 years. A 68-year-woman with HCM underwent trans-aortic myectomy of the interventricular septum in 1979. A significant amount of round cell infiltration, myocardial fibrosis and disarray were observed in the resected specimen. She experienced repeated admissions due to diabetes mellitus and congestive heart failure, and died of renal failure in 1989. An autopsy revealed extensive myocardial fibrosis and significant cell infiltration in the ventricular myocardium. The infiltrating cells were almost all lymphocytes, and the ratio of CD4 to CD8 was 3.8. This ratio was different from that of typical viral myocarditis. This case suggests that there may be an undefined inflammatory process causing fibrosis in HCM, in addition to the ischemia due to intramural small coronary artery stenosis.
Kawano et al. (Sat,) conducted a case report in Hypertrophic Cardiomyopathy (n=1). Pathological examination was evaluated on Pathological findings (myocardial fibrosis and cell infiltration). Autopsy of a 68-year-old woman with hypertrophic cardiomyopathy revealed extensive myocardial fibrosis and significant lymphocytic infiltration with a CD4 to CD8 ratio of 3.8, suggesting an undefined inflammatory process.