Unexpected autopsy findings after sudden cardiac death: Cardiovascular myxoedema and endocardial fibroelastosis

Effects of short‐term levothyroxine therapy on myocardial injuries in patients with severe overt hypothyroidism: Evidence from a cardiac MRI Study

“…Autopsy studies have reported myofibrillar swelling with loss of striation and diffuse interstitial fibrosis as the pathological hallmark of cardiovascular involvement in HT . Also, abundant mucopolysaccharides were found in the fibroblasts, which formed compact masses in the ventricular endocardium . Accumulation of mucopolysaccharides (glycosaminoglycans) in the interstitium due to lack of thyroid hormones was thought to play a crucial pathophysiological role in the development of diffuse myocardial fibrosis and myxedema in HT .…”

“…6 Also, abundant mucopolysaccharides were found in the fibroblasts, which formed compact masses in the ventricular endocardium. 7 Accumulation of mucopolysaccharides (glycosaminoglycans) in the interstitium due to lack of thyroid hormones was thought to play a crucial pathophysiological role in the development of diffuse myocardial fibrosis and myxedema in HT. 8 Thus, diffuse myocardial interstitial injuries may be closely associated with the development of cardiac remodeling, and their presence is correlated with adverse clinical outcomes.…”

Native Magnetic Resonance T1-Mapping Identifies Diffuse Myocardial Injury in Hypothyroidism

“…Thus, T1 mapping is a potential additional quantitative tool for detection of cardiac involvement in HT patients. As both fibrosis and oedema, which likely coexist in HT patients [ 25 ], would increase native T1 values, it may be challenging to distinguish these two pathological changes based on imaging alone.…”

“…One of the distinctive factors of HT cardiomyopathy pathology is diffuse interstitial space expansion, which normally occurs through the development of fibrosis. Overt HT also can lead to myocardial oedema due to the extensive deposits of acid mucopolysaccharide [ 25 ]. T1 mapping is a potential useful toll in assessing HT patients with diffuse fibrosis and oedema.…”

Peeling the left ventricle as treatment for endocardial fibroelastosis: An exceptional surgical procedure in adults

“…Other pathogenetic mechanisms have been reported to play a significant role in the development of endocardial fibroelastosis, such as genetic factors, viral infection, or the transplacental passage of anti-Ro and anti-La antibodies. 6 Endocardial fibroelastosis should not be confused with endomyocardial fibrosis. Endocardial fibroelastosis is characterized by a thickening of the innermost lining of the heart chambers (but with only the endocardium affected) as a result of an increase in the amount of connective tissue and elastic fibers.…”