Fenoglio J J, Pham T D, Hordof A, Edie R N, Wit A L
Am J Cardiol. 1979 Apr;43(4):820-7. doi: 10.1016/0002-9149(79)90084-5.
Portions of operatively resected right atrium from 15 patients with atrial septal defect were studied ultrastructurally to determine whether the cell hypertrophy in the right atrium of patients with increased right atrial blood flow and increased right atrial pressure is caused by the increased blood flow. In 12 patients with normal right atrial mean pressure but increased right atrial blood flow the atrium was dilated but no atrial arrhythmias were noted clinically. Ultrastructurally, the atrial myocardial cells in these patients were normal, measuring 6 to 10 mu in diameter, and there was no evidence of cell hypertrophy or degeneration. The remaining three patients had elevated right atrial mean pressure and increased right atrial blood flow. Ultrastructurally, the atrial myocardial cells in all three patients were hypertrophied, and two patients had evidence of focal cell degeneration; the atrium was markedly dilated, but atrial arrhythmias were not noted. The lack of cell hypertrophy in the right atrium of the 12 patients with increased blood flow but normal mean pressure suggests that in congenital heart disease volume overload alone does not lead to cell hypertrophy of the right atrial myocardium.
对15例房间隔缺损患者手术切除的右心房组织进行超微结构研究，以确定右心房血流增加和右心房压力升高患者的右心房细胞肥大是否由血流增加引起。12例右心房平均压力正常但右心房血流增加的患者，心房扩张，但临床上未发现房性心律失常。超微结构显示，这些患者的心房心肌细胞正常，直径为6至10微米，没有细胞肥大或变性的证据。其余3例患者右心房平均压力升高且右心房血流增加。超微结构显示，所有3例患者的心房心肌细胞均肥大，2例有局灶性细胞变性的证据；心房明显扩张，但未发现房性心律失常。12例血流增加但平均压力正常的患者右心房缺乏细胞肥大，这表明在先天性心脏病中，单纯的容量超负荷不会导致右心房心肌细胞肥大。
