Murphy M L, White H J, Meade J, Straub K D
Cardiology Section, Veterans Administration Medical Center, Little Rock, Arkansas.
Clin Cardiol. 1988 May;11(5):297-302. doi: 10.1002/clc.4960110505.
Confusion may exist at the time of postmortem examination as to whether the diseased heart is dilated, hypertrophied, or both. Ventricular dilatation and ventricular hypertrophy were therefore evaluated by cardiac partition techniques in 441 subjects at autopsy to determine their relationship. Specific weight and surface area of each ventricle were obtained and patients were divided into categories of disease. Wall thickness measurements, a parameter routinely used in the ordinary autopsy, were found to be unreliable in defining hypertrophy. Ventricular surface area (an index of dilatation) was highly correlated with ventricular weight in most disease categories. Exceptions were cardiomyopathy and aortic stenosis, in which hypertrophy predominated. We conclude from these data that dilatation and hypertrophy occur proportionately in the postmortem heart in most disease categories except in cardiomyopathy and aortic stenosis. These findings clarify the relationship of dilatation and hypertrophy at the time of autopsy in most cases. Therefore, uncertainty as to whether cardiac dilatation or hypertrophy is present or which predominates is usually related to the inability to assess these states critically at the time of autopsy when the ordinary pathological methods are used.
在尸检时，对于患病心脏是扩张、肥厚还是两者皆有，可能会存在混淆。因此，通过心脏分区技术对441名尸检对象的心室扩张和心室肥厚进行了评估，以确定它们之间的关系。获取了每个心室的比重和表面积，并将患者分为不同疾病类别。发现壁厚测量（普通尸检中常规使用的一个参数）在定义肥厚方面不可靠。在大多数疾病类别中，心室表面积（扩张指标）与心室重量高度相关。心肌病和主动脉狭窄是例外，其中以肥厚为主。从这些数据中我们得出结论，在大多数疾病类别中，除了心肌病和主动脉狭窄外，尸检心脏中的扩张和肥厚成比例发生。这些发现澄清了大多数情况下尸检时扩张与肥厚的关系。因此，关于心脏是否存在扩张或肥厚以及哪种情况占主导的不确定性，通常与在尸检时使用普通病理方法无法准确评估这些状态有关。
