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- Number 2 - Proceedings of the second symposium on ...
- Diffuse myocardial fibrosis in ischaemic heart disease
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Diffuse myocardial fibrosis in ischaemic heart disease
Abstract
The amount of connective tissue was determined morphometrically in the left ventricular myocardium of 123 autopsy hearts. Patients with a history or signs of systemic diseases (such as arterial hypertension or diabetes mellitus) or of non-ischaemic heart disease were excluded. Three tissue samples from the left ventricle (anterior and posterior walls, interventricular septum) were cut at 5 μm. They were stained with Masson trichrome stain, and the amount of connective tissue was estimated by a point counting method in a projection microscope at a magnification of 200. A square lattice with 36 points was used. In hearts with coronary artery narrowing more than 10% in terms of area of the luminal cross section, but devoid of any recent or old myocardial infarct, the volume fraction of fibrosis +- SD was 4.1% +- 1.1% (controls 2.6% +- 0.8). Hearts with infarct scars contained 6.3-6.6% diffuse connective tissue. In hearts with acute infarcts only (no scars) the corresponding figure was 3.2%. The results show that also limited coronary artery narrowing is associated with diffuse myocardial fibrosis. In fatal acute myocardial infarcts, the amount of diffuse fibrosis remains low, whereas in hearts with scars from earlier infarcts with or without acute infarct diffuse fibrosis is severe.