Rossi M A
Department of Pathology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Int J Cardiol. 1991 Mar;30(3):335-40. doi: 10.1016/0167-5273(91)90012-e.
Observations are described on the fibrillar nature and structural features of the collagenous interstices of the human myocardium in chronic chagasic cardiomyopathy, comparing them with similar observations in normal hearts, using the picrosirius red technique and polarization microscopy. A total of 28 adult hearts obtained at autopsy were used: 5 control without evidence of cardiac disease, and 23 with chronic Chagas' heart disease. The findings in the myocardium of those without Chagas' disease were in keeping with those reported in the literature. In those with Chagas' disease diffuse interstitial fibrosis could be observed in all cases, albeit to varying degree. The pattern was that of a diffuse increase in the amount of thick collagen fibers surrounding bundles of muscle fibers (perimysial matrix), varying in intensity from one area to another, and around the intramyocardial coronary vessels, combined with a less pronounced increase in the matrix of endomysial collagen. The relationship between the observed myocardial fibrosis and cardiac function, and the potential mechanisms for its production, are discussed. Further research is needed into the patterns and pathogenesis of myocardial fibrosis in order to offer possibilities for prevention and development of corrective forms of therapy for the fibrotic process.
运用天狼星红染色技术和偏振显微镜，对慢性恰加斯病性心肌病患者心肌胶原间隙的纤维性质和结构特征进行了观察，并与正常心脏的类似观察结果进行比较。共使用了28例成人尸检心脏：5例无心脏病证据的对照心脏，以及23例患有慢性恰加斯心脏病的心脏。无恰加斯病患者心肌的观察结果与文献报道一致。在患有恰加斯病的患者中，所有病例均可见弥漫性间质纤维化，但程度各异。其模式为围绕肌纤维束（肌束膜基质）的粗大胶原纤维数量弥漫性增加，不同区域强度不同，且围绕心肌内冠状动脉血管，同时肌内膜胶原基质的增加不太明显。讨论了观察到的心肌纤维化与心脏功能之间的关系及其产生的潜在机制。为了为纤维化过程的预防和开发纠正性治疗形式提供可能性，需要对心肌纤维化的模式和发病机制进行进一步研究。
