Surgical pathology of subaortic septal myectomy associated with hypertrophic cardiomyopathy. A study of 204 cases (1996-2000) - PubMed (original) (raw)
Case Reports
Surgical pathology of subaortic septal myectomy associated with hypertrophic cardiomyopathy. A study of 204 cases (1996-2000)
Geoffrey T Lamke et al. Cardiovasc Pathol. 2003 May-Jun.
Abstract
Background: No large surgical series have qualitatively examined all histopathologic features of hypertrophic cardiomyopathy (HCM).
Methods: Medical records and microscopic slides were reviewed from 204 patients undergoing septal myectomy for HCM at Mayo Clinic Rochester.
Results: The 108 females and 96 males (1-86 years old; mean, 48) included 133 patients <60 years old (Group 1) and 71 patients > or =60 years (Group 2). Clinical features more prevalent in Group 2 than in Group 1 included female gender (68% vs. 45%; P=.003), aortic valve disease (31% vs. 12%; P=.01) and severe coronary atherosclerosis (43% vs. 9%; P=.001). Overall, microscopic abnormalities included myocyte hypertrophy (100%), endocardial (96%) and myocardial (93%) fibrosis, myocyte disarray (79%) and vacuolization (60%), endocardial inflammation (48%), arterial thickening (46%), dilated venules (28%), arterial dysplasia (16%), left bundle branch tissue (12%), infarction (2%), endocardial (1%) and myocardial (<1%) calcium, and amyloid (1%; senile type in all three). Lesions more prevalent in Group 1 than Group 2 were vacuolization (68% vs. 45%; P=.002), disarray (87% vs. 65%; P=.0003) and dilated venules (33% vs. 18%; P=.02). In contrast, lesions more frequent in Group 2 than in Group 1 included left bundle branch (20% vs. 8%; P=.02) and amyloid and endocardial calcium (4% vs. 0%; P=.04, each).
Conclusions: Among patients undergoing septal myectomy for HCM, 53% were women and 35% were >/=60 years old. The most common microscopic features were hypertrophy, disarray, fibrosis, inflammation and vascular alterations. Disarray cannot be used as a morphologic hallmark for HCM in small surgical myectomy specimens because it was absent in 21% of the patients. Because amyloid unexpectedly affected three elderly patients, routine amyloid staining is recommended for patients >/=65 years old.
Similar articles
- Surgical pathology of subaortic septal myectomy not associated with hypertrophic cardiomyopathy: a study of 98 cases (1996-2000).
Allen RD, Edwards WD, Tazelaar HD, Danielson GK. Allen RD, et al. Cardiovasc Pathol. 2003 Jul-Aug;12(4):207-15. doi: 10.1016/s1054-8807(03)00057-7. Cardiovasc Pathol. 2003. PMID: 12826290 - Surgical pathology of subaortic septal myectomy: histology skips over clinical diagnosis.
Abecasis J, Gouveia R, Castro M, Andrade MJ, Ribeiras R, Ramos S, Abecasis M, Cardim N, Gil V. Abecasis J, et al. Cardiovasc Pathol. 2018 Mar-Apr;33:32-38. doi: 10.1016/j.carpath.2017.12.002. Epub 2018 Jan 3. Cardiovasc Pathol. 2018. PMID: 29414430 - Myocardial Histopathology in Patients With Obstructive Hypertrophic Cardiomyopathy.
Cui H, Schaff HV, Lentz Carvalho J, Nishimura RA, Geske JB, Dearani JA, Lahr BD, Lee AT, Bos JM, Ackerman MJ, Ommen SR, Maleszewski JJ. Cui H, et al. J Am Coll Cardiol. 2021 May 4;77(17):2159-2170. doi: 10.1016/j.jacc.2021.03.008. J Am Coll Cardiol. 2021. PMID: 33926651 - Hypertrophic Obstructive Cardiomyopathy: Surgical Myectomy and Septal Ablation.
Nishimura RA, Seggewiss H, Schaff HV. Nishimura RA, et al. Circ Res. 2017 Sep 15;121(7):771-783. doi: 10.1161/CIRCRESAHA.116.309348. Circ Res. 2017. PMID: 28912182 Review. - Tailored Planning of Surgical Myectomy in Obstructive Hypertrophic Cardiomyopathy.
Koo HJ, Lee SA, Jung SH, Kang JW, Yang DH. Koo HJ, et al. Radiographics. 2024 Jan;44(1):e230050. doi: 10.1148/rg.230050. Radiographics. 2024. PMID: 38060425 Review.
Cited by
- T1 Mapping in cardiomyopathy at cardiac MR: comparison with endomyocardial biopsy.
Sibley CT, Noureldin RA, Gai N, Nacif MS, Liu S, Turkbey EB, Mudd JO, van der Geest RJ, Lima JA, Halushka MK, Bluemke DA. Sibley CT, et al. Radiology. 2012 Dec;265(3):724-32. doi: 10.1148/radiol.12112721. Epub 2012 Oct 22. Radiology. 2012. PMID: 23091172 Free PMC article. - Left Ventricular Outflow Tract Obstruction Due to Cardiac Hamartoma.
Techasatian W, Pham A, Nishimura Y, Banerjee D. Techasatian W, et al. Cureus. 2024 Jun 19;16(6):e62721. doi: 10.7759/cureus.62721. eCollection 2024 Jun. Cureus. 2024. PMID: 39036200 Free PMC article. - Delayed hyperenhancement in magnetic resonance imaging of left ventricular hypertrophy caused by aortic stenosis and hypertrophic cardiomyopathy: visualisation of focal fibrosis.
Debl K, Djavidani B, Buchner S, Lipke C, Nitz W, Feuerbach S, Riegger G, Luchner A. Debl K, et al. Heart. 2006 Oct;92(10):1447-51. doi: 10.1136/hrt.2005.079392. Epub 2006 Apr 10. Heart. 2006. PMID: 16606864 Free PMC article. - Feline hypertrophic cardiomyopathy: reduced microvascular density and involvement of CD34+ interstitial cells.
Rodríguez JMM, Fonfara S, Hetzel U, Kipar A. Rodríguez JMM, et al. Vet Pathol. 2022 Mar;59(2):269-283. doi: 10.1177/03009858211062631. Epub 2021 Dec 27. Vet Pathol. 2022. PMID: 34955067 Free PMC article. - The Immune and Inflammatory Basis of Acquired Pediatric Cardiac Disease.
Jui E, Singampalli KL, Shani K, Ning Y, Connell JP, Birla RK, Bollyky PL, Caldarone CA, Keswani SG, Grande-Allen KJ. Jui E, et al. Front Cardiovasc Med. 2021 Jul 27;8:701224. doi: 10.3389/fcvm.2021.701224. eCollection 2021. Front Cardiovasc Med. 2021. PMID: 34386532 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical