Hoshino T, Fujiwara H, Kawai C, Hamashima Y
Circulation. 1983 May;67(5):1109-16. doi: 10.1161/01.cir.67.5.1109.
Myocardial fiber diameters were measured to determine their distribution throughout the ventricular wall in normal adult hearts, hypertensive hearts and hearts with hypertrophic cardiomyopathy (HCM). In normal adult hearts and hypertensive hearts, the diameter decreased from the inner to the outer third of the left ventricular free wall and from the left ventricular side to the right ventricular side of the septum. In HCM, these regional differences were preserved in the left ventricular free wall, but not in the septum. The diameter was greatest in the middle third of the septum, where myocardial fiber disarray was widely distributed. The diameters of the fibers in the right ventricular side of the septum were significantly larger than those of the fibers in the left ventricular side of the septum in HCM. This finding, in contrast to that in normal adult hearts or hypertensive hearts, was considered to be related to the inward convex curvature of the left ventricular chamber. Although there was no significant difference in the diameter of myocardial fibers in the left ventricular free wall between hypertensive hearts and hearts with HCM, the diameters of those in the right ventricular free wall, in the right ventricular side of the septum and in the middle third of the septum were significantly larger in HCM than in hypertensive hearts. We conclude that there is a transmural variation of myocardial fiber diameter in the left ventricular free wall and the ventricular septum, and such transmural variation in HCM is clearly different from that in hypertensive hearts.
测量了正常成年心脏、高血压心脏和肥厚型心肌病(HCM)心脏的心肌纤维直径,以确定其在整个心室壁中的分布。在正常成年心脏和高血压心脏中,左心室游离壁从内层到外层三分之一以及室间隔从左心室侧到右心室侧,直径逐渐减小。在HCM中,左心室游离壁保留了这些区域差异,但室间隔没有。室间隔中间三分之一处直径最大,此处心肌纤维紊乱广泛分布。在HCM中,室间隔右心室侧的纤维直径明显大于室间隔左心室侧的纤维直径。这一发现与正常成年心脏或高血压心脏不同,被认为与左心室腔的内向凸曲率有关。尽管高血压心脏和HCM心脏的左心室游离壁心肌纤维直径没有显著差异,但HCM中右心室游离壁、室间隔右心室侧和室间隔中间三分之一处的纤维直径明显大于高血压心脏。我们得出结论,左心室游离壁和室间隔存在心肌纤维直径的透壁变化,且HCM中的这种透壁变化与高血压心脏明显不同。