Abstract:P M A, Mioto B M, Chabelmann R C, Oliveira S A -Estudo comparativo do anel valvar mitral e do ventrículo esquerdo na cardiomiopatia dilatada. Material e Métodos: Analisaram-se 68 corações humanos adultos, fixados, sendo 48 portadores de CMD de etiologia isquêmica ou idiopática, e 20 corações sem cardiopatia. Obteve-se imagens digitalizadas do perímetro do anel mitral, inserção da cúspide anterior e posterior e da porção fibrosa e muscular. Obteve-se também o perímetro interno do VE, distância do septo ao músc… Show more
“…From a macroscopic point of view, it was noted that there dilatation in both ventricles of the idDCM group, albeit with distinct morphology, since the expansion of the RVR accompanies the expansion of the equatorial and basal ventricular segments, contrary to what happens in LVR which presents no significant expansion compared to the control group, although there was dilation of equatorial and basal segments at left. In relation to LVR, these findings confirm the results of Juliani [ 22 ] and Hueb et al [ 2 , 3 ] , who claim to not be the degree of left ventricular dilation that determines the degree of dilation of the mitral ring, since they occur independently. This statement has always been a matter of controversy in the literature.…”
Section: Discussionsupporting
confidence: 88%
“…Ventricular remodeling characterized by both right and left morphogeometrical changes, provides vicious cycle of functional deterioration, since the heart loses its original anatomical conformation, which is critical to its efficiency. In this context, the valve insufficiency caused primarily by expansion of the atrioventricular rings is of paramount importance [ 1 ] , but despite this relevant fact, the rings expansion mechanism is not completely understood [ 2 - 4 ] .…”
Section: Introductionmentioning
confidence: 99%
“…The anatomical concept that the fibrous skeleton of the heart does not dilate has been refuted [ 2 , 3 , 18 ] , and its enlargement has been proved in cases of severe heart failure due to dilated cardiomyopathy of ischemic (iscDCM) or nonchagasic idiopathic (idDCM) etiologies [ 2 , 3 ] ; however, it does not exist in the literature comparative histological study of right and left atrioventricular rings in cases of idDCM in light of this new concept. At the same time, available knowledge about the role played by ECM in terms of control and regulation of this process is still scarce so that there is broad field of research being done in this area.…”
IntroductionIdiopathic dilated cardiomyopathy causes great impact but many aspects of its
pathophysiology remain unknown.ObjectiveTo evaluate anatomical and histological aspects of hearts with idiopathic dilated
cardiomyopathy and compare them to a control group, evaluating the behavior of the
perimeters of the atrioventricular rings and ventricles and to compare the
percentage of collagen and elastic fibers of the atrioventricular rings.MethodsThirteen hearts with cardiomyopathy and 13 normal hearts were analysed. They were
dissected keeping the ventricular mass and atrioventricular rings, with lamination
of segments 20%, 50% and 80% of the distance between the atrioventricular groove
and the ventricular apex. The sections were subjected to photo scanning, with
measurement of perimeters. The atrioventricular rings were dissected and measured
digitally to evaluate their perimeters, later being sent to the pathology
laboratory, and stained by hematoxylin-eosin, picrosirius and oxidized resorcin
fuccin.ResultsRegarding to ventricles, dilation occurs in all segments in the pathological
group, and the right atrioventricular ring measurement was higher in idiopathic
dilated cardiomyopathy group, with no difference in the left side. With respect to
collagen, both sides had lower percentage of fibers in the pathological group.
With respect to the elastic fibers, there was no difference between the
groups.ConclusionThere is a change in ventricular geometry in cardiomyopathy group. The left
atrioventricular ring does not dilate, in spite of the fact that in both
ventricles there is lowering of collagen.
“…From a macroscopic point of view, it was noted that there dilatation in both ventricles of the idDCM group, albeit with distinct morphology, since the expansion of the RVR accompanies the expansion of the equatorial and basal ventricular segments, contrary to what happens in LVR which presents no significant expansion compared to the control group, although there was dilation of equatorial and basal segments at left. In relation to LVR, these findings confirm the results of Juliani [ 22 ] and Hueb et al [ 2 , 3 ] , who claim to not be the degree of left ventricular dilation that determines the degree of dilation of the mitral ring, since they occur independently. This statement has always been a matter of controversy in the literature.…”
Section: Discussionsupporting
confidence: 88%
“…Ventricular remodeling characterized by both right and left morphogeometrical changes, provides vicious cycle of functional deterioration, since the heart loses its original anatomical conformation, which is critical to its efficiency. In this context, the valve insufficiency caused primarily by expansion of the atrioventricular rings is of paramount importance [ 1 ] , but despite this relevant fact, the rings expansion mechanism is not completely understood [ 2 - 4 ] .…”
Section: Introductionmentioning
confidence: 99%
“…The anatomical concept that the fibrous skeleton of the heart does not dilate has been refuted [ 2 , 3 , 18 ] , and its enlargement has been proved in cases of severe heart failure due to dilated cardiomyopathy of ischemic (iscDCM) or nonchagasic idiopathic (idDCM) etiologies [ 2 , 3 ] ; however, it does not exist in the literature comparative histological study of right and left atrioventricular rings in cases of idDCM in light of this new concept. At the same time, available knowledge about the role played by ECM in terms of control and regulation of this process is still scarce so that there is broad field of research being done in this area.…”
IntroductionIdiopathic dilated cardiomyopathy causes great impact but many aspects of its
pathophysiology remain unknown.ObjectiveTo evaluate anatomical and histological aspects of hearts with idiopathic dilated
cardiomyopathy and compare them to a control group, evaluating the behavior of the
perimeters of the atrioventricular rings and ventricles and to compare the
percentage of collagen and elastic fibers of the atrioventricular rings.MethodsThirteen hearts with cardiomyopathy and 13 normal hearts were analysed. They were
dissected keeping the ventricular mass and atrioventricular rings, with lamination
of segments 20%, 50% and 80% of the distance between the atrioventricular groove
and the ventricular apex. The sections were subjected to photo scanning, with
measurement of perimeters. The atrioventricular rings were dissected and measured
digitally to evaluate their perimeters, later being sent to the pathology
laboratory, and stained by hematoxylin-eosin, picrosirius and oxidized resorcin
fuccin.ResultsRegarding to ventricles, dilation occurs in all segments in the pathological
group, and the right atrioventricular ring measurement was higher in idiopathic
dilated cardiomyopathy group, with no difference in the left side. With respect to
collagen, both sides had lower percentage of fibers in the pathological group.
With respect to the elastic fibers, there was no difference between the
groups.ConclusionThere is a change in ventricular geometry in cardiomyopathy group. The left
atrioventricular ring does not dilate, in spite of the fact that in both
ventricles there is lowering of collagen.
“…The LV dilation almost always stretches the mitral annulus, but contrary to expectations, the degree of dilation of the LV and annulus may worsen somewhat independently from one another [13]. In dilated annulus, the physiological systolic annular contraction is compromised and added to the restriction on systolic excursion of the leaflets, culminates in FMI.…”
Section: Anatomy and Physiology Of The Mitral Valvementioning
confidence: 84%
“…Besides the aforementioned, it is worth noting the morphological study of Hueb et al [13] in 2001, which changed the paradigm that the mitral annular dilatation spared the implantation of the anterior leaflet. The authors demonstrated that this portion of the mitral annulus is also dilated, although to a lesser degree.…”
Section: Brazilian Contribution In the Correction Of The Functional Mmentioning
In veterinary, there is scarce availability of morphogeometric studies in normal and remodeled hearts; furthermore, ventricular geometry acts as an indicator of cardiac function. It is a highly necessary field of knowledge for the development of therapeutic protocols, especially surgical ones. The objectives of this study were: to obtain measurements of the left atrioventricular valve ring and left ventricle, to analyze the proportionality between the segments of the left cardiac chamber of normal hearts and to describe reference values for morphogeometric analysis of the left ventricle. For this, 50 hearts from small (Group 1—G1) and medium to large (Group 2—G2) dogs were laminated in the apical, basal and equatorial segments, and submitted to computer analysis to identify the perimeter of each segment and the left atrioventricular ring, wall thickness and distance from the atrioventricular sulcus to the apex. The largest internal perimeter was that of the equatorial. The basal segment had the highest mean for ventral parietal wall thickness, suggesting greater contractile reserve at that location. Considering the proportionality relationships, there was no statistical difference between the intersegmental perimeter indices for the two groups. This suggests that despite the animals’ weight variations, the proportions between the left ventricular segments are maintained. Therefore, it is concluded that the data can be used as a standard of comparison for cardiac geometric assessments, as well as a basis for the development of therapeutic measures in the context of adverse cardiac remodeling.
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