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  • 1
    ISSN: 1615-2573
    Keywords: Endomyocardial biopsy ; Dilated cardiomyopathy ; Children ; Ultrastructure ; Basal lamina layering of capillary
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We analyzed the electron-microscopic features of endomyocardial biopsy from pediatric patients with dilated cardiomyopathy (DCM). The specimens examined were taken from the right ventricle of ten patients aged from 2 to 15 years (mean 9.7 years). Biopsy specimens from eight patients with congenital heart disease (tetralogy of Fallot), aged from 3 to 12 (mean 7.3 years), and ten adult patients with DCM, aged from 32 to 60 (mean 45 years), were also examined. Patients considered to have endocardial fibroelastosis, arrhythmogenic right ventricular cardiomyopathy, specific cardiomyopathy, or coronary heart disease were excluded from this study. Specimens from pediatric patients with DCM showed various degrees of ultrastructural abnormalities of myocytes, including myofibrillar fragmentation, mitochondrial abnormalities, and intracellular edema. The ultrastructurally determined contractility failure index based on the severity of myocardial degeneration at the electronmicroscopic level was 4.9 ± 1.1. This value was significantly higher than that in patients with tetralogy of Fallot (0.9 ± 0.6,P 〈 0.001) but was not significantly different from that in adult patients with DCM (6.1 ± 2.6). The index of pediatric patients with DCM who died within 3 years was high (6.0 ± 0.8). Basal lamina layering of a capillary (BLL) in the myocardium was revealed in 1 of the 10 (10%) pediatric patients with DCM and in 6 of the 10 (60%) adult patients with DCM (P 〈 0.05). No BLL was noted in the patients with tetralogy of Fallot. These findings may be related to the pathogenesis of DCM in children and adults.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1615-2573
    Keywords: Dilated cardiomyopathy ; Myocarditis ; Endomyocardial biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of an 11-month-old infant who was incidentally diagnosed as having myocarditis by right and left ventricular endomyocardial biopsy is reported. This patient was admitted because of heart failure. Chest X-ray showed cardiomegaly and an electrocardiogram revealed decreased voltage with right atrial and right ventricular overloading. A dilated left ventricle with poor ejection fraction was shown in an echocardiogram. Dilated cardiomyopathy was the initial diagnosis since there was no episode of preceding viral infection or evidence of an inflammatory process in routine laboratory investigations. However, the biopsy findings, including massive infiltration of inflammatory cells and myocyte degeneration, indicated myocarditis. To our knowledge, this is the youngest patient in whom myocarditis has been confirmed by endomyocardial biopsy.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1860-1499
    Keywords: Immunoelectron microscopy ; Dilated cardiomyopathy ; Immunocytochemistry ; Desmin filament
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Desmin filaments specific for muscle cells, normally localized at the Z band level and intercalated discs, may play an important role in maintaining the structure of the cardiomyocytes. By immunoelectron microscopy, we examined the distribution of desmin in endomyocardial biopsy samples of 10 patients with dilated cardiomyopathy. We found an increased number of desmin filaments characterized by a disordered arrangement in the myocytes. Desmin immunolabeling was transversely and longitudinally distributed at the Z band level and near the intercalated discs within the cytoplasm of the myocytes lacking myofilaments. These data suggest that desmin filaments could play a role in the defence mechanisms of the cardiomyocytes threatened by stress overloading in the diseased human heart.
    Type of Medium: Electronic Resource
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