特発性心筋症および僧帽弁狭窄症における生検心筋の電子顕微鏡的研究

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Since the introduction of endomyocardial biopsy catheter, or "bioptome", by Sakakibara and Konno in 1962, biopsies of the myocardium as well as the endocardium have been safely and easily performed without thoracotomy in our laboratory. The purpose of this paper is to present histological,especially electron microscopic, findings on the biopsied specimens obtained form (1) the right and left ventricles in patients with idiopathic cardiomyopathy for the diagnostic confirmations and etiologic investigations, and (2) the right ventricles in patients with mitral stenosis showing various degrees of pulmonary hypertension for the study of myocardial factor in the pathogenesis of heart failure. Materials and Methods In the present series, the endomyocardial biopsy was performed following the routine cardiac catheterization study. An intravascular biopsy catheter was introduced into the right ventricle via the left antecubital or right saphenous vein, and the left ventricle via the left brachial artery under the fluoroscopic control with the aid of intracardiac ECG monitoring. A few of small specimens of cardiac tissue, usually 2 mm in diameter, including endocardium and myocardium were excised from the apex near the septum in the right ventricle and from the free wall near the apex in the left ventricle. The specimens used for the light microscopic examinations were were fixed in 10% neutral formalin solution. The sections were prepared in the usual manner, and stained with hematoxylineosin, Mallory-azan, van Gieson Weigert and periodic acid Schiff. For the electron microscopic study the another specimens were fixed in 3 to 4% glutaraldehyde and/or phosphate-buffered osmium tetroxide, dehydrated through a graded series of alcohols and propyrene oxide, and embedded in Epon 812. Sections were then made with a Porter Blum MT-2 ultramicrotome, stained with uranyl acetate and/or lead citrate, and examined with Hitachi HU-11-A electron microscope. Electron microscopic observations were mainly focused on the muscle fibers in the present study. It should be mentioned, therefore, that the findings as to interstitial tissues including blood vessels will not discussed in this paper. Ten patients with idiopathic cardiomyopathy, including one with idiopathic hypertrophic subaortic stenosis (IHSS) and one with postpartum heart disease, and 8 patients with mitral stenosis were studied. Bioposied specimens of the myocardium obtained from a patient who was initially suspected to have idiopathic cardiomyopathy but turned out to be apparently normal following a series of laboratory studies were served as controls.
社団法人日本循環器学会の論文
1971-11-20

特発性心筋症および僧帽弁狭窄症における生検心筋の電子顕微鏡的研究

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