[Changes of heart geometry in patients with ischemic heart disease]. / Serganciuju isemine sirdies liga sirdies geometrijos pokyciai.

OBJECTIVE: The aim of the study was to determine ventricular and atrial cardiometric parameters at preinfarction and postinfarction stage of ischemic heart disease. OBJECT AND METHODS: Cardiometric parameters (mass, endocardial surface area, the tracts of flow and outflow, etc.) of 132 men (mean age of 49.7+/-8.9 years) who had died suddenly during prehospital period (within 6 hours) after the first or repeated acute event of "pure" ischemic heart disease were investigated. These patients had no other, except ischemia, factors predisposing myocardial hypertrophy as well as clinical symptoms of heart failure. The decedents were divided into preinfarction (71 men) and postinfarction ischemic heart disease (61 men) groups. RESULTS: At preinfarction stage of ischemic heart disease, mass and endocardial surface area of all parts of the heart were increased, the tracts of flow and outflow--longer. At postinfarction stage, only corresponding left ventricular and atrial parameters were more increased. CONCLUSIONS: Eccentric type of left ventricular hypertrophy (proportional increase of mass and endocardial surface area) and concentric type of right ventricular and right and left atrial hypertrophy (the part of myocardium mass per unit of endocardial area is greater) were determined at preinfarction stage of ischemic heart disease. At postinfarction stage, at least as far as evidence of heart failure is not overt, only the corresponding left ventricular and atrial hypertrophy progresses.

Cardiomyocyte remodeling in ischemic heart disease.

OBJECTIVE: The aim of the study was to detect changes in left ventricular cardiomyocyte size and shape in response to chronic ischemia and loss of cardiac tissue (myocardial infarction) during the course of ischemic heart disease (IHD). MATERIAL AND METHODS: Left ventricular cardiomyocyte dimensions (diameter and length) were estimated histomorphometrically, and their cross-sectional area and volume were assessed in 85 males who died suddenly out of hospital (within 6 hours of the onset of the terminal event) due to the acute first (preinfarction IHD group, n=53, aged 48.6+/-2.9 years) or repeated (postinfarction IHD group, n=32, aged 51.7+/-2.9 years) IHD attack, and had no other causes for the increased heart load. Twenty-nine males of similar age (mean age, 46.0+/-3.1 years) who succumbed to external causes served as controls. RESULTS: We have found cardiomyocyte hypertrophy in the preinfarction IHD group already. The cardiomyocyte volume was increased by 32.0% in comparison with the same index in the control group, and cross-sectional area and length--by 17.2 and 12.5%, respectively. In postinfarction IHD group, all studied cardiomyocyte parameters did not differ significantly from the analogous indices in the preinfarction IHD group (P>0.05). Cardiomyocyte hypertrophy was related to the increase in left ventricular cardiomyocyte parameters. CONCLUSIONS: Left ventricular cardiomyocyte hypertrophy occurs before the first myocardial infarction. In postinfarction myocardium, cardiomyocyte dimensions do not differ significantly at least prior to the appearance of congestive heart failure syndrome.

[Results of morphologic epidemiologic study of coronary arteries in Kaunas population aged 20-69 years: atherosclerotic lesions and their interrelationship]. / 20-69 metu Kauno gyventoju sirdies vainikiniu arteriju morfologinio epidemiologinio tyrimo duomenys: ateroskleroziniai pazeidimai ir ju sasaja.

OBJECTIVE: The object of study was the type, frequency and extent, as well as correlation of atherosclerotic lesions in Kaunas population aged 20-69 years. RESULTS: The frequency and intimal area of raised atherosclerotic lesions (fibrous and complicated plaque and calcinosis) are age-dependent. The increase of raised lesions area seems to alter at different decades of life. In men the most substantial progression in left anterior descending artery was observed at the fourth-fifth, in right coronary artery--at the fifth, and in both arteries of women - at the sixth decade of life. The area of fatty streaks is not dependent on age and comprises approximately 4-5% of intimal surface. We observed weak negative correlation between area of raised lesions and fatty streaks, and strong correlation between the area of all type of raised lesions in all three coronary arteries. CONCLUSIONS: The coronary artery atherosclerosis is progressing with age. Age decades, when increase of raised lesion area is observed, correspond to age periods, in which mortality due to ischemic heart disease increases significantly.