Ethical considerations preclude the biopsy of normal human myocardium. As a consequence, morphological investigations of diseased human heart muscle are hampered by a lack of suitable normal control tissue. The left ventricular (LV) myocardium of patients with isolated secundum atrial septal defect (ASD) is considered to be normal. This study was designed to investigate the possibility that the fine-structure of LV myofibres in hearts with ASD could be used as normal controls for myofibre pathomorphology. Wedge biopsies from the LV of four adults undergoing elective surgery for the repair of ASD were examined by light and electron microscopy. Bivariant myofibre morphometry showed that the LV myocardium of one specimen was 'normal' while three specimens exhibited varying degrees of hypertrophy. There was a correlation between the diameter (FD) and morphology of individual myofibres within and between specimens. In general, myofibres with FD less than 25 microns were similar in fine-structural appearance to those described as morphologically normal in animal models whereas those with FD greater than 25 microns exhibited hypertrophic features that increased in 'severity' with increase in myofibre size. It is proposed that although the LV myocardium in ASD may be mildly hypertrophied, myofibres with FD less than 25 microns are probably normal and may be used as fine-structural controls for myofibre pathomorphology in hearts suspected of disease.

译文

伦理考虑排除了正常人心肌的活检。结果,由于缺乏合适的正常对照组织,阻碍了患病人心肌的形态学研究。孤立的继发性房间隔缺损 (ASD) 患者的左心室 (LV) 心肌被认为是正常的。这项研究旨在研究ASD心脏中LV肌纤维的精细结构可以用作肌纤维病理形态学的正常对照的可能性。通过光学和电子显微镜检查了四名接受择期手术以修复ASD的成年人的LV的楔形活检。双变型肌纤维形态测定表明,一个标本的LV心肌是 “正常的”,而三个标本则表现出不同程度的肥大。标本内部和之间的单个肌纤维的直径 (FD) 与形态之间存在相关性。通常,FD小于25微米的肌纤维在精细结构外观上与动物模型中描述为形态正常的肌纤维相似,而FD大于25微米的肌纤维表现出肥厚特征,随着肌纤维大小的增加,其 “严重” 增加。有人提出,尽管ASD中的LV心肌可能轻度肥大,但FD小于25微米的肌纤维可能是正常的,可以用作怀疑有疾病的心脏中肌纤维病理形态的精细结构对照。

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