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Interstitial cell infiltrate and myocardial fibrosis in dilated cardiomyopathy: A special type of cardiomegaly corresponding to sequelae of myocarditis

Heart and Vessels volume 5, pages 230–236 (1990)Cite this article

Summary

We examined the relationship between interstitial cell infiltration and myocardial fibrosis in patients with clinically diagnosed dilated cardiomyopathy (DCM). Forty-two cases of DCM were divided into two groups, according to the mean number of the interstitial round cells per 10.2×104 square µm (Nic): the inflammatory group (Nic ≥5) and noninflammatory group (Nic<5). The 12 cases in the inflammatory group were clinically similar to the 30 cases in the non-inflammatory group, but the inflammatory group exhibited a significantly (P<0.001) larger area of myocardial fibrosis (34.8%±12.8% vs 17.5%±8.2%), a significantly (P<0.01) higher frequency of diffuse perimyocytic-type fibrosis (83% vs 23%), fewer myocardial cells in the left ventricular wall (170±70 fibers vs 216±81 fibers), and significantly (P<0.01) greater hypertrophy of the myocytes (18.3±3.4 vs 15.3±2.7 µm). In addition, cases exhibiting marked fibrosis (fibrosis area ≥25% of the myocardium) had a significantly higher Nic score (8.3±6.8) compared to cases with the less fibrotic type of DCM (4.0±5.7).

We speculate that persistent or preceding inflammatory cell infiltration induces the myocardial fibrosis, especially the diffuse perimyocytic type, in the fibrosis-predominant type of DCM. Therefore, most of these cases may be a sequela of myocarditis, and more correctly termed post-myocarditic cardiomegaly.

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  1. Research Laboratory for Cardiovascular Pathology, Division of Cardiology, Department of Internal Medicine, School of Medicine, Juntendo University, 2-1-1 Hongo, 112, Bunkyo-ku, Tokyo, Japan

    Sachio Kawai & Ryozo Okada

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  1. Sachio Kawai
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  2. Ryozo Okada
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Kawai, S., Okada, R. Interstitial cell infiltrate and myocardial fibrosis in dilated cardiomyopathy: A special type of cardiomegaly corresponding to sequelae of myocarditis. Heart Vessels 5, 230–236 (1990). https://doi.org/10.1007/BF02058695

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  • DOI: https://doi.org/10.1007/BF02058695

Key words

  • Chronic fibroplastic myocarditis
  • Myocardial fibrosis
  • Inflammation
  • Post-myocarditic cardiomegaly