Interstitial fibrosis in the dilated non-ischaemic myocardium

A Brooks, V Schinde, AC Bateman, PJ Gallagher - Heart, 2003 - heart.bmj.com
A Brooks, V Schinde, AC Bateman, PJ Gallagher
Heart, 2003heart.bmj.com
METHODS Forty four hearts were selected from approximately 500 necropsies of adults who
died in the community or at Southampton University Hospitals over a six month period. For
case selection mitral valve circumference was measured. Hearts with a mitral valve
circumference> 110 mm were provisionally assigned to the test (dilated) group and those<
110 mm to the control group. Five criteria were then considered. If any of these applied to the
hearts from either the test or the control group, they were excluded from further study. These …
METHODS
Forty four hearts were selected from approximately 500 necropsies of adults who died in the community or at Southampton University Hospitals over a six month period. For case selection mitral valve circumference was measured. Hearts with a mitral valve circumference> 110 mm were provisionally assigned to the test (dilated) group and those< 110 mm to the control group. Five criteria were then considered. If any of these applied to the hearts from either the test or the control group, they were excluded from further study. These were (1) a clinical history of ischaemic heart disease;(2) macroscopic evidence of old or recent ischaemic heart disease;(3) any stenosis> 50% of the external diameter of a major epicardial coronary artery;(4) valvar or congenital cardiac disease apart from mild thickening of the anterior mitral valve leaflet; and (5) treatment with angiotensin converting enzyme inhibitors. In the selected hearts the following were measured: mitral valve circumference (mm), cutting the chordae tendineae to facilitate straightening of the valve rim, aortic valve circumference (mm), thickness of the free wall of the left ventricle and the interventricular septum 10 mm below the mitral valve ring (mm), thickness of the interventricular septum at the base of the papillary muscles (mm), thickness of the free wall of the right ventricle 20 mm below the pulmonary valve (mm), the distance from the apex of the left ventricle to the base of the mitral valve annulus (mm), and the weights of the right ventricle, left ventricle, and interventricular septum (g). To estimate left ventricular volume (cm 3) we used an equation that assumes that the cavity is conical in shape, 0.83 (Ax), where A is the area of the mitral valve annulus (cm 2) and x the distance from the mitral valve annulus to the apex of the left ventricle (cm).
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