Pangonyte Dalia, Morkūnaite Kristina, Stalioraityte Elena, Zaikauskiene Jolanta
Laboratory of Cardiac Pathology, Institute of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
Medicina (Kaunas). 2007;43(2):125-30.
The aim of this study was to determine atrial structural remodeling during the development of ischemic heart disease.
Quantitative histomorphometric parameters of interstitial collagen network (the percentage volume, perimeter, number of fibers per field and collagen-cardiomyocyte volume ratio) of the atria of 132 autopsied men (mean age 49.7+/-8.9 years) who had died suddenly (within 6 hours since the onset of terminal heart attack symptoms) due to the first (no postinfarction scars) and repeated (postinfarction scars present) acute "pure" ischemic heart disease were investigated.
The main remodeling feature of the wall of the both atria among ischemic heart disease subjects is hypertrophy of cardiomyocytes and hyperplasia of interstitial fibrillar collagen network with the maintenance of the same proportion of contractile myocardium and fibrillar collagen network volume. This proportion in the case of the left atrium persists in both pre- and postinfarction ischemic heart disease groups, while myocardium of the right atrium in preinfarction group subjects is characterized by an excess increase of collagen network as compared to cardiomyocyte hypertrophy, which levels again with that of the control in postinfarction group.
At preinfarction stage of ischemic heart disease, remodeling of both atria develops and progresses in the left atrium at postinfarction stage in the relationship with increase of left ventricular dysfunction.
本研究旨在确定缺血性心脏病发展过程中的心房结构重塑。
对132名男性尸检者（平均年龄49.7±8.9岁）的心房间质胶原网络的定量组织形态学参数（体积百分比、周长、每视野纤维数量以及胶原 - 心肌细胞体积比）进行了研究。这些男性因首次（无心肌梗死后瘢痕）和反复（存在心肌梗死后瘢痕）急性“单纯”缺血性心脏病突然死亡（在终末期心脏病发作症状出现后6小时内）。
缺血性心脏病患者双侧心房壁的主要重塑特征是心肌细胞肥大和间质纤维状胶原网络增生，同时收缩性心肌和纤维状胶原网络体积保持相同比例。左心房的这一比例在心肌梗死前和心肌梗死后缺血性心脏病组中均持续存在，而心肌梗死前组右心房心肌的特征是胶原网络的增加超过心肌细胞肥大，在心肌梗死后期该比例与对照组再次持平。
在缺血性心脏病的心肌梗死前期，双侧心房均发生重塑，在心肌梗死后期，左心房重塑与左心室功能障碍的增加有关，且继续发展。
