Five patients with only mildly dilated ventricles but other features typical of congestive cardiomyopathy underwent cardiac transplantation for class IV NYHA heart failure. The findings of clinical studies, cardiac catheterization, endomyocardial biopsy, and pathologic examination of the removed hearts in this group with mildly dilated congestive cardiomyopathy (MDCM) were compared with similar data in four patients with idiopathic restrictive cardiomyopathy (IRCM) and in 10 patients with typical dilated congestive cardiomyopathy (DCM). In comparison with the other groups, patients with MDCM had a higher incidence of familial cardiomyopathy (p = .02) and a shorter symptomatic period than patients with IRCM (p < .02). Patients with both MDCM and DCM had globular hearts (with predominant left ventricular dilatation), congestive hemodynamics and poor left ventricular contractility (ejection fraction 12% to 1.9%), and high incidence of ventricular thrombi. Patients with IRCM showed normal ventricular size, marked atrial dilatation, restrictive hemodynamics, mild-tomoderate decrease in left ventricular contractility (ejection fraction 29% to 55%), and absence of ventricular thrombi. Cardiac index, ventricular wall thickness, and light microscopic findings were similar in the three groups of patients. Electron microscopy showed no myofibrillar loss in patients with IRCM but mild (partial) or moderate-to-severe (almost total) myofibrillar loss in those with MDCM and DCM, respectively. We conclude that (1) end-stage congestive cardiomyopathy may occur without significant ventricular dilatation and (2) 302-309, 1985. CONGESTIVE and restrictive cardiomyopathies represent distinct entities with different hemodynamic and morphologic features.' Congestive cardiomyopathy is characterized by ventricular dilatation and poor systolic function with greatly reduced ejection fraction.' Dilatation of the ventricles usually occurs earlier than heart failure and is considered the most important manifestation of the disease. 5 For this reason, the terms "dilated"2'6 or "dilated congestive"3' 4 cardiomyopathy are currently preferred. Light and electron microscopic assessment show major but nonspecific abnormal changes.' 1. 6 Restrictive cardiomyopathy is characterized by normal or near normal ventricular size and systolic function but compromised ventricular relaxation leading to distinctive hemodynamic findings. 4 The term re-
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.