Department of Clinical Anatomy, Gdansk Medical University, Gdansk, Poland.
Department of Forensic Medicine, Gdansk Medical University, Gdansk, Poland.
Folia Morphol (Warsz). 2022;81(2):336-342. doi: 10.5603/FM.a2021.0038. Epub 2021 Apr 26.
In the case of long-term and physiological loads (e.g. during pregnancy or regular athletics training), reversible morphological changes occur in the heart - cardiomyocytes undergo hypertrophy; however, this is not accompanied by impairment of left ventricular function or myocyte metabolism. However, in the course of various pathological processes, as time goes by, gradually permanent morphological changes occur. These changes are referred to as remodelling of the heart muscle, which, regardless of the primary cause, can lead to the development of chronic heart failure.
The study was performed on post-mortem material of 35 human hearts obtained from forensic sections and anatomopathological sections of people who died of non-cardiac causes (mainly traffic accidents, suicide attempts, strokes, acute infections); material was fixed in a 4% formalin solution. The hearts were subjected to macro- and microscopic assessment. During microscopic assessment the features of remodelling were evaluated.
In vivo and echocardiographic tests, as well as macroscopic evaluation of post-mortem material, suggest the presence of some kind of right ventricular muscle remodelling; however, classic microscopic observations, presented in this study, do not provide such unambiguous evidence. Thus, the question arises: why and how the right ventricular function is disturbed, sometimes at early stages of arterial hypertension.
在长期和生理负荷（例如在怀孕期间或定期进行运动训练期间）的情况下，心脏会发生可逆的形态变化 - 心肌细胞发生肥大；然而，这不会伴随左心室功能或心肌代谢的损害。然而，在各种病理过程中，随着时间的推移，逐渐会发生永久性的形态变化。这些变化被称为心肌重构，无论其主要原因是什么，都可能导致慢性心力衰竭的发展。
本研究使用了 35 个人类心脏的尸检材料，这些心脏是从因非心脏原因（主要是交通事故、自杀未遂、中风、急性感染）死亡的人的法医和解剖病理学部分获得的；材料固定在 4%的福尔马林溶液中。对心脏进行了宏观和微观评估。在微观评估过程中，评估了重构的特征。
体内和超声心动图检查以及对死后材料的宏观评估表明存在某种右心室肌肉重构；然而，本研究中呈现的经典微观观察结果并没有提供如此明确的证据。因此，出现了这样一个问题：为什么以及如何在动脉高血压的早期阶段，右心室功能就会受到干扰。
