Key result
Autopsied cases of hypertrophic cardiomyopathy with heart failure and a small left ventricle had larger myocytes and less fibrosis compared to control hypertrophic cardiomyopathy.
Case Report (n=2)
Hypertrophy of myocytes and/or myocardial fiber disarray, rather than fibrosis, may be important in the pathogenesis of severe congestive heart failure in hypertrophic cardiomyopathy with a small left ventricular cavity.
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May implicate myocyte hypertrophy over fibrosis in small-LV HCM failure; hypothesis-generating and should not yet change practice.
To clarify the morphologic basis of marked congestive heart failure in cases of hypertrophic cardiomyopathy with a small left ventricular cavity, the size of myocytes, the extent of myocardial fiber disarray and fibrosis were quantitatively evaluated in two autopsied cases. Compared with the control hypertrophic cardiomyopathy, both cases had larger myocytes and less fibrosis, and one of them had markedly extensive myocardial fiber disarray. Probably, the hypertrophy of the myocytes or myocardial fiber disarray or both rather than myocardial fibrosis are important in the pathogenesis of severe congestive heart failure in these cases.
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Tanaka et al. (1987) conducted a case report in Hypertrophic cardiomyopathy with congestive heart failure and a small left ventricular cavity (n=2). Hypertrophic cardiomyopathy with congestive heart failure and a small left ventricular cavity vs. Control hypertrophic cardiomyopathy was evaluated on Size of myocytes, extent of myocardial fiber disarray, and fibrosis. Autopsied cases of hypertrophic cardiomyopathy with heart failure and a small left ventricle had larger myocytes and less fibrosis compared to control hypertrophic cardiomyopathy.
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