Fenoglio J J, Irey N S
Am J Pathol. 1977 Oct;89(1):51-8.
Although consideral information is available concerning the structural and biochemical changes in the skeletal muscles of patients with malignant hyperthermia, little is known of the cardiac changes in this disease. However, ventricular fibrillation and cardiac arrest are frequent in these patients. In 3 patients with malignant hyperthermia, contraction bands and foci of myofiberlysis were found in the heart at necropsy. Ultrastructurally, areas of myofiber overstretching adjacent to contraction bands and foci of extensive myofiberlysis were associated with disruptions of the sarcolemma. Similar ultrastructural findings have been reported in the skeletal muscles of these patients and are thought responsible for the hyperkalemia which is a constant feature of malignant hyperthermia. Our findings suggest that the ventricular arrhythmias, frequent in this disease, are the result of direct damage to cardiac muscle rather then secondary to elevated plasma levels of potassium.
尽管已有大量关于恶性高热患者骨骼肌结构和生化变化的信息，但对于该疾病中心脏的变化却知之甚少。然而，这些患者常出现心室颤动和心脏骤停。在3例恶性高热患者尸检时，发现心脏存在收缩带和肌纤维溶解灶。超微结构上，收缩带和广泛肌纤维溶解灶附近的肌纤维过度伸展区域与肌膜破裂有关。在这些患者的骨骼肌中也有类似的超微结构发现，并且认为这是导致恶性高热中持续存在的高钾血症的原因。我们的研究结果表明，该疾病中常见的室性心律失常是心肌直接损伤的结果，而非继发于血浆钾水平升高。
