Morphometric Structure of the Failing Left Ventricular Myocardium in Aortic Valve Disease Before and After Valve Replacement

  • H. P. Krayenbühl
  • O. M. Hess
  • E. S. Monrad
  • J. Schneider
  • G. Mall
  • M. Turina
Conference paper

Abstract

Chronic pressure and/or volume overload in aortic valve disease is associated with marked left ventricular angiographic [l–3] as well as cellular hypertrophy [4,5]. This process of secondary hypertrophy is accompanied by an increase in interstitial tissue. Are the microscopic alterations different in patients with preserved and depressed left ventricular function? Comparing intraoperative transmural biopsies from patients with compensated and decompensated aortic stenosis, Schwarz et al. [6] found a reduced volume fraction of myofibrils in those with depressed left ventricular function. In patients with aortic insufficiency and a massively impaired left ventricular ejection fraction of 32%, volume fraction of myofibrils was smaller and muscle fiber diameter larger than in patients with aortic insufficiency and only a moderately depressed ejection fraction of 48% [7]. The purpose of the present study was to evaluate left ventricular morphometric structure from endomyocardial biopsies in patients with aortic valve disease with compensated and failing left ventricles and to report changes of morphometric variables at an intermediate time after aortic valve replacement.

Keywords

Cardiol 

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References

  1. 1.
    Gould KL, Kennedy JW, Frimer M, Pollack GH, Dodge HT (1976) Analysis of wall dynamics and directional components of left ventricular contraction in man. Am J Cardiol 38: 322–331PubMedCrossRefGoogle Scholar
  2. 2.
    Gunther S, Grossman W (1979) Determinants of ventricular function in pressure-overload hypertrophy in man. Circulation 59: 679–688PubMedCrossRefGoogle Scholar
  3. 3.
    Herreman F, Ameur A, De Vernejoul F, Bourgin JG, Gueret P, Guerin F, Degeorges M (1979) Pre-and post-operative hemodynamic and cineangiographic assessment of left ventricular function in patients with aortic regurgitation. Am Heart J 98: 63–72PubMedCrossRefGoogle Scholar
  4. 4.
    Schaper J, Schwarz F, Hehrlein F (1981) Ultrastructural changes in human myocardium with hypertrophy due to aortic valve disease arid their relationship to left ventricular mass and ejection fraction. Herz 6: 217–225PubMedGoogle Scholar
  5. 5.
    Hess OM, Ritter M, Schneider J, Grimm.J, Turina M, Krayenbuehl HP (1984) Diastolic stiffness and myocardial structure in aortic valve disease before and after valve replacement. Circulation 69: 855–865PubMedCrossRefGoogle Scholar
  6. 6.
    Schwarz F, Schaper J, Kittstein D, Flameng W, Walter P, Schaper W (1981) Reduced volume fraction of myofibrils in myocardium of patients with decompensated pressure overload. Circulation 63: 1299–1304PubMedCrossRefGoogle Scholar
  7. 7.
    Perennec J, Herreman F, Cosma H, tiers F, Djigouadi Z, Degeorges M, Hatt PY (1988) Relationship of myocardial morphometry in aortic valve regurgitation to myocardial function and post-operative results. Basic Res Cardiol 83: 10–23PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • H. P. Krayenbühl
  • O. M. Hess
  • E. S. Monrad
  • J. Schneider
  • G. Mall
  • M. Turina

There are no affiliations available

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