Histopathological analysis of abnormal electrocardiographic findings in hypertrophic cardiomyopathy With biopsied ventricular myocardium.:With Biopsied Ventricular Myocardium
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概要
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To clarify the relationship between electrocardiographic abnor malities and the histopathology of hypertrophic cardiomyopathy (HCM), 43 cases of HCM were studied electrocardiographically observing 1) abnormal Q waves, 2) QRS axis and voltages, 3) depth of negative P waves in V<SUB>1</SUB>, 4) giant negative T waves and 5) degree of ST segment depression. Each biopsied specimen was checked microscopically for 1) hypertrophy, 2) disarray and 3) fibrosis. Hypertrophy was graded from (0) to (3+) by the mean value of the shortest transverse diameters of at least 30 myocytes under hematoxylin-eosin stain. Disarray was graded from (0) to (3+) according to the degree of disarrangement of the myocytes under phosphotungstic acid-hematoxylin stain. Fibrosis was graded from (0) to (3+) by the % area counting method under Malloryazan stain. Multiple abnormal Q waves were associated with fibrosis in the presence of hypertrophy (p<0.01). HCM with SV<SUB>1</SUB>+RV<SUB>5-6</SUB><35 mm had significantly more advanced fibrosis (p<0.001) and disarray (p<0.01) than HCM with SV<SUB>1</SUB>+RV<SUB>5-6</SUB>≥35 mm. The depth of the negative P in V<SUB>1</SUB> reflected the degree of hypertrophy, disarray and fibrosis in HCM. HCM with giant negative T waves and ST segment depression (≥ 2 mm) had significantly milder fibrosis (p<0.01) and milder disarray (p<0.05) in the presence of hypertrophy.
- 久留米大学医学部 The Kurume Medical Journal 編集部の論文