[Significance of morphological findings in congestive cardiomyopathy].

In 48 consecutive patients with myocardial disease, left ventricular biopsies were taken during diagnostic heart catheterization. Morphometric quantification of ultrastructural alterations of the heart muscle was performed. The patients were subdivided into 3 groups by means of clinical criteria: Group A: 18 surviving patients with pathological ECG, normal left ventricular ejection fraction, and normal coronary arteries. The mean follow-up in this group was 22 months. Group B: 23 surviving patients with congestive cardiomyopathy, i.e., normal coronary arteries and depressed left ventricular ejection fraction. The mean follow-up in this group was 23 months. Group C: 7 patients with congestive cardiomyopathy, who died during the study period from cardiac complications. The mean survival time of these patients after heart catheterization was 23 months. Myocardial fiber diameter, volume fraction of interstitial fibrosis, intracellular volume fraction of myofibrils, and the total myofibrillar mass per 100 g heart muscle were determined by light microscopic morphometry. In a pilot study comprising 26 patients the reproducibility of the morphological results were assessed by investigation of two different biopsy specimens taken from different areas of the left ventricular wall of each patient. The study revealed a coefficient of variation of 6% for myocardial fiber diameter, 28% for myocardial fibrosis, and 4% for myofibrillar volume fraction. Since there are only poor results from morphological investigations of the diseased myocardium, it was the purpose of the follow-up study presented in this paper: To quantify ultrastructural alterations of the heart in congestive cardiomyopathy by morphometric techniques. To correlate the quantitative morphometric data with the contractile state of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)