Publication:
Routine histopathology of septal myectomy for hypertrophic obstructive cardiomyopathy in a greek cohort

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Ioakeimidis-36-1145-1153-2021.pdf(24.49 MB)
Date
2021
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Authors
Ioakeimidis, Nikolaos S. ; Pitsis, Antonios ; Ntelios, Dimitrios ; Zegkos, Thomas ; Kelpis, Timotheos ; Papamitsou, Theodora ; Parcharidou, Despoina ; Efthimiadis, Georgios ; Meditskou, Soultana
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-369
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info:eu-repo/semantics/article
Description
Abstract
Hypertrophic cardiomyopathy (HCM) is a diverse inherited disease affecting 1 in 500 individuals irrespective of gender and ethnicity. A fraction of HCM patients will eventually develop drug refractory dynamic obstruction of the left ventricular outflow tract. For such patients, septal myectomy is the procedure of choice to alleviate their symptoms and improve their quality of life. The current histopathological study, the first from the Greek region, aims to examine the hallmark histopathological characteristics of Hypertrophic Obstructive Cardiomyopathy in a population of patients undergoing septal myectomy at a single center over a ten year period. Medical records and histopathology specimens of thirty nine (n=39) patients were evaluated. The sample comprised 22 males (56.4%) and 17 females (43.6%). Mean patient age at myectomy was 53.9±16.7 years, ranging from 12 to 79 years. Maximal IVS thickness on echocardiography was available for 35 patients with a median value of 2.08cm. Peak resting LVOT Pressure Gradient was available for 33 patients with a mean value of 104.88±44.20 mmHg. Central tendency of each histopathological attribute expressed as the median value was: moderate for myocyte hypertrophy, mild for cytoplasmic vacuolization, moderate for subendocardial fibrosis, moderate for interstitial fibrosis, mild for replacement fibrosis, moderate for myofibrillar disarray and mild for capillary stenosis. Myocyte hypertrophy, present in all specimens, was positively correlated with maximal IVS thickness (tau-b=0.43, p=0.002). Replacement fibrosis was positively correlated with the grade of microvascular stenosis (tau-b=0.45, p=0.004). LVEF was negatively correlated with the grade of interstitial fibrosis (taub=−0.43, p=0.035) and with the extent of myocardial fiber disarray (tau-b=−0.42, p=0.034). Histopathological attributes were not correlated with patient gender or age thus proving that HCM has a histological phenotype unique to each patient, mainly depending on each specific sarcomeric mutation
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Hypertrophic Cardiomyopathy , Myectomy , Cardiac Pathology , Cardiac Histology
Citation
Histology and Histopathology Vol. 36, nº11 (2021)
URI
http://hdl.handle.net/10201/128003
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Histology and histopathology Vol.36,nº11 (2021)
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