Myocardial disorganisation in hypertrophic cardiomyopathy. Another point of view.

Maron, Barry J.

doi:10.1136/hrt.50.1.1

Cited by 21 publications

(2 citation statements)

References 18 publications

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“…Furthermore, Becker and Caruso [201] showed that this histological feature could be detected in normal hearts, particularly at the junction of the interventricular septum and free wall of the right ventricle. Despite all this controversy, Maron [202] feels strongly convinced that myofiber disarray is pathognomonic of HOCM if it is accompanied by other histopathologic features such as fibrosis, abnormal hyperchromatic muscle fiber nuclei, and perinuclear haloes. Rose [203] has recently carried out an interesting and most elegant study on autopsy material of HOCM and has demonstrated a significantly higher incidence of sudden death in those cases that were shown to have a higher histologic HOCM index, and he now plans to assess EMB in this respect.…”

Section: Diagnosis Of Hypertrophic Cardiomyopathymentioning

confidence: 99%

Endomyocardial biopsy: A review of the literature

Przybojewski

1985

Cathet. Cardiovasc. Diagn.

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A review of the literature relating to endomyocardial biopsy (EMB) is presented. This is considered important at this time since EMB is being utilized with increasing frequency, particularly for the diagnosis of myocarditis. The development of the technique is briefly outlined. Emphasis is placed on the clinical application of EMB in the various primary cardiomyopathies (dilated, hypertrophic, restrictive, and obliterative), the infiltrative secondary cardiomyopathies (amyloidosis, sarcoidosis, hemochromatosis), myocarditis, as well as such conditions as adriamycin cardiotoxicity, cardiac transplant rejection, and Kawasaki disease. More controversial application of EMB in primary mitral valve prolapse (Barlow's syndrome), idiopathic ventricular arrhythmias, and the elucidation of the enigmatic finding of angina with angiographically normal coronary arteries is detailed. Experience with immunological and biochemical investigation of biopsy material, as well as with virus isolation and drug assays in the myocardium, is alluded to. Complications encountered with this procedure are also discussed, and its future role is contemplated.

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Section: Diagnosis Of Hypertrophic Cardiomyopathymentioning

confidence: 99%

Endomyocardial biopsy: A review of the literature

Przybojewski

1985

Cathet. Cardiovasc. Diagn.

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“…However, a (semi-) quantitative assessment used alone is vulnerable to the argument that the disarray may merely represent a basically normal myofibre architecture (Becker & Caruso 1982) or it may be associated with some condition other than HCM. Maron (1983) stresses that it is the considerable extent of the myofibre disarray that separates hypertrophic cardiomyopathy from other lesions producing left ventricular hypertrophy and from normal hearts.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of pathological criteria for diagnosis of hypertrophic cardiomyopathy

Rose

1984

Histopathology

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This study aims to evaluate and compare the current pathological criteria for the diagnosis of hypertrophic cardiomyopathy (HOCM). The following criteria were applied to 39 autopsy patients whose hearts showed myofibre disarray: (i) disarray involving more than 5% of ventricular septal myofibres, (ii) asymmetrical septal hypertrophy (ASH), (iii) mirror-image subaortic plaque, and (iv) a positive histologic HOCM index (HHI). Group 1 (27 patients) with greater than 5% ventricular septal myofibre disarray were diagnosed as HCM, whereas group 2 (12 patients) had less than 5% disarray. The mean disarray value in group 1 was 52% compared to 1.2% in group 2. The two groups showed significant differences regarding ASH and in the amounts of myofibre disarray in the free walls of both ventricles. A new finding was that the histologic HOCM index was significantly higher in patients who died suddenly. The HHI was the commonest positive criterion in group 1, followed by ASH and a mirror-image endocardial plaque. None of the current imperfect pathological criteria for the diagnosis of HCM can be used as the 'gold standard'.

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