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Basic Pathological Processes of the Heart

Relationship to Cardiomyopathies

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Physiology and Pathophysiology of the Heart

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 90))

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Abstract

Cardiomyopathy is broadly denned as heart muscle disease. The purpose of this chapter is to review certain basic pathological processes affecting the heart and to discuss the relationship of these processes to various cardiomyopathies. Additional information regarding several of these pathological processes is provided in other chapters of this book.

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References

  1. Hillis LD, Braunwald E: Myocardial ischemia. N Engl J Med 296: 971–978, 1034–1041, 1093–1096, 1977.

    Article  PubMed  CAS  Google Scholar 

  2. Willerson JT, Hillis LD, Buja LM: Pathogenesis and pathology of ischemic heart disease. In: Ischemic Heart Disease: Clinical and Pathophysiological Aspects. New York: Raven Press, 1982.

    Google Scholar 

  3. Willerson JT, Buja LM: Myocardial infarction—1983. Clin Res 31: 364–375, 1983.

    Google Scholar 

  4. Buja LM Willerson JT: Clinicopathologic findings in acute ischemic heart disease syndromes. Am J Cardiol 47: 343–356, 1981.

    Article  PubMed  CAS  Google Scholar 

  5. Buja LM, Hillis LD, Petty SC, Willerson JT: The role of coronary arterial spasm in ischemic heart disease. Arch Pathol Lab Med 105: 221–226, 1981.

    PubMed  CAS  Google Scholar 

  6. Hirsh PD, Campbell WB, Willerson JT, Hillis LD: Prostaglandins and ischemic heart disease. Am J Med 71: 1009–1026, 1981.

    Article  PubMed  CAS  Google Scholar 

  7. Shepherd JT, Vanhoutte PM: Spasm of the coronary arteries: Causes and consequences (the scientist’s viewpoint). Mayo Clin Proc 60: 33–46, 1985.

    PubMed  CAS  Google Scholar 

  8. Fuster V, Steele PM, Chesebro JH: Role of platelets and thrombosis in coronary atherosclerotic disease and sudden death. J Am Coll Cardiol 5 (Suppl): 175B–184B, 1985.

    Google Scholar 

  9. Willerson JT, Hillis LD, Winniford M, Buja LM: Speculation regarding mechanisms responsible for acute ischemic heart disease syndromes. J Am Coll Cardiol 8: 245–250, 1986.

    Article  PubMed  CAS  Google Scholar 

  10. Cobb LA, Werner JA, Trobaugh GB: Sudden cardiac death. I. A decade’s experience with out-of-hospital resuscitation. Mod Concepts Cardiovasc Dis 49: 31–36, 1980.

    PubMed  CAS  Google Scholar 

  11. Reimer KA, Jennings RB: The “wavefront phenomenon” of myocardial ischemic cell death. II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow. Lab Invest 40: 633–644, 1979.

    PubMed  CAS  Google Scholar 

  12. Willerson JT, Parkey RW, Bonte FJ, Lewis SE, Corbett J, Buja LM: Pathophysiologic considerations and clinicopathological correlates of technetium-99m stannous pyrophosphate myocardial scintigraphy. Sem Nucl Med 10: 54–69, 1980.

    Article  CAS  Google Scholar 

  13. Hagler H, Burton K, Buja L: Electron probe x-ray microanaysis of normal and injured myocardium: Methods and results. In: Hutchinson TE, Somlyo AP (eds) Microprobe Analysis of Biological Systems. New York: Academic Press, 1981, pp 245–281.

    Google Scholar 

  14. Buja LM, Willerson JT: Abnormalities of volume regulation and membrane integrity in myocardial tissue slices after early ischemic injury in the dog: Effects of mannitol, polyethylene glycol and propranolol. Am J Pathol 103: 79–95, 1981.

    PubMed  CAS  Google Scholar 

  15. Burton KP, Hagler HK, Willerson JT, Buja LM: Relationship of abnormal intracellular lanthanum accumulation to progression of ischemic injury in isolated perfused myocardium: Effect of chlorpromazine. Am J Physiol: Heart and Circ Physiol 241: H714–H723, 1981.

    CAS  Google Scholar 

  16. Chien KR, Reeves JP, Buja LM, Bonte F. Parkey RW, Willerson JT: Phospholipid alterations in canine ischemic myocardium. Temporal and topographical correlations with Tc-99m-PPi accumulation and an in vitro sarcolemmal Ca2+ permeability defect. Circ Res 48: 711–719, 1981.

    PubMed  CAS  Google Scholar 

  17. Chien KR, Sen A, Reynolds R, Chang A, Kim Y, Gunn MD, Buja LM, Willerson JT: Release of arachidonate from membrane phospholipids in cultured neonatal rat myocardial cells during adenosine triphosphate depletion: Correlation with the progression of cell injury. J Clin Invest 75: 1770–1780, 1985.

    Article  PubMed  CAS  Google Scholar 

  18. Mukherjee A, Bush LR, McCoy KE, Duke RJ, Hagler H, Buja LM, Willerson JT: Relationship between ß-adrenergic receptor numbers and physiological responses during experimental canine myocardial ischemia. Circ Res 50: 735–741, 1982.

    PubMed  CAS  Google Scholar 

  19. Corr PB, Shayman JA, Kramer JB, Kipnis RJ: Increased alpha adrenergic receptors in ischemic cat myocardium: A potential mediator of electrophysiological derangements. J Clin Invest 67: 1232–1236, 1981.

    Article  PubMed  CAS  Google Scholar 

  20. Müntz KH, Hagler HK, Boulas HJ, Willerson JT, Buja LM: Redistribution of catecholamines in the is¬chemic zone of the dog heart. Am J Pathol 114: 64–78, 1984.

    PubMed  Google Scholar 

  21. Willerson JT, Buja LM: Short-and long-term influence of beta-adrenergic antagonists after acute myocardial infarction. Am J Cardiol 54 (Suppl E): 16E–20E, 1984.

    Article  PubMed  CAS  Google Scholar 

  22. Reichenbach DD, Benditt EP: Catecholamines and cardiomyopathy: The pathogenesis and potential im¬portance of myofibrillar degeneration. Human Pathol 1: 125–150, 1970.

    Google Scholar 

  23. Buja LM, Ferrans VJ, Roberts WC: Drug-induced cardiomyopathies. In: Homburger F (ed) Comparative Pathology of the Heart, Advances in Cardiology, Vol 13. Basel: Karger, 1974, pp 330–348.

    Google Scholar 

  24. Buja LM, Ferrans VJ: Myocardial injury produced by antineoplastic drugs. In: Fleckenstein A, Rona G (eds) Pathophysiology and Morphology of Myocardial Cell Alteration, Recent Advances in Studies on Cardiac Structure and Metabolism, Vol 6. Baltimore: University Park Press, 1975, pp 487–497.

    Google Scholar 

  25. Rubin E: Alcohol: Toxic or tonic? Cardiovasc Rev Rep 2: 23–29, 1981.

    Google Scholar 

  26. Csapo Z, Dusek J, Rona G: Early alterations of the cardiac muscle cells in isoproterenol-induced necrosis. Arch Pathol 93: 356–365, 1972.

    PubMed  CAS  Google Scholar 

  27. Rona G, Boutet M, Huttner I, Peters H: Pathogenesis of isoprotereol-induced myocardial alterations: Functional and morphological correlates. In: Dhalla NS (ed) Myocardial Metabolism, Recent Advances in Studies on Cardiac Structure and Metabolism, Vol 3- Baltimore, University Park Press, 1973, pp 507 - 525.

    Google Scholar 

  28. Downing SE, Lee JC: Contribution of alpha adeno-receptor activation to the pathogenesis of norepinephrine cardiomyopathy. Circ Res 52: 471–478, 1983.

    PubMed  CAS  Google Scholar 

  29. Ferrans VJ: Overview of cardiac pathology in relation to anthracycline cardiotoxicity. Cancer Treat Rep 62: 995–961, 1978.

    Google Scholar 

  30. Young RC, Ozols RF, Myers CE: The anthracycline antineoplastic drugs. N Engl J Med 305: 139–153, 1981.

    Article  PubMed  CAS  Google Scholar 

  31. Olson RD, Boerth RC, Gerber JG, Nies AS: Mechanisms of adriamycin cardiotoxicity: Evidence for oxidative stress. Life Sci 29: 1393–1401, 1981.

    Article  PubMed  CAS  Google Scholar 

  32. Jackson JA, Reeves JP, Müntz KH, Kruk D, Prough RA, Willerson JT, Buja LM: Evaluation of free-radical effects and catecholamine alterations in adriamycin cardiotoxicity. Am J Pathol 117: 140–153, 1984.

    PubMed  CAS  Google Scholar 

  33. Dalbow DG, Jaenke RS: In vivo RNA synthesis in the hearts of adriamycin-treated rats. Cancer Res 42: 79–83, 1982.

    PubMed  CAS  Google Scholar 

  34. Bristow MR, Minobe WA, Billingham ME, Marmor JB, Johnson GA, Ishimoto BM, Sageman WS, Daniels JR: Anthracycline-associated cardiac and renal damage in rabbits: Evidence for mediation by vasoactive substances. Lab Invest 45: 157–168, 1981.

    PubMed  CAS  Google Scholar 

  35. Lerner AM, Wilson FM: Virus myocardiopathy. Prog Med Virol 15: 63–91, 1973.

    PubMed  CAS  Google Scholar 

  36. Abelman WH: Viral myocarditis and its sequelae. Ann Rev Med 22: 145–152, 1973.

    Article  Google Scholar 

  37. Woodruff JF: Viral myocarditis: A review. Am J Pathol 101: 425–484, 1980.

    PubMed  CAS  Google Scholar 

  38. Cambridge G, MacArthur CGC, Waterson AP, Goodwin JF, Oakley CM: Antibodies to Coxsackie B viruses in congestive cardiomyopathy. Brit Heart J 41: 692–696, 1979.

    Article  PubMed  CAS  Google Scholar 

  39. 39- Kirsner AB, Hess EV, Fowler NO: Immunologic findings in idiopathic cardiomyopathy: A prospective serial study. Am Heart J 86: 625–630, 1973.

    Article  PubMed  CAS  Google Scholar 

  40. Bolte HD, Schultheiss P: Immunological results in myocardial diseases. Postgrad Med J 54: 500–503, 1978.

    Article  PubMed  CAS  Google Scholar 

  41. Jacobs B, Matsuda Y, Deodhar S, Shirey E: Cell-mediated cytotoxicity to cardiac cells of lymphocytes from patients with primary myocardial disease. Am J Clin Pathol 72: 1–4, 1979.

    PubMed  CAS  Google Scholar 

  42. Fowles RE, Dieber CP, Stinson EB: Defective in vitro suppressor cell function in idiopathic congestive card-iomyopathy. Circulation 59: 483–491, 1979.

    PubMed  CAS  Google Scholar 

  43. Hang LM, Izui S, Dixon FJ: (NZW x BXSB) Fi hybrid: A model of acute lupus and coronary vascular disease with myocardial infarction. J Exp Med 154: 216–221, 1981.

    Article  PubMed  CAS  Google Scholar 

  44. Meerson FZ: The myocardium in hyperfunction, hypertrophy and heart failure. Circ Res 24 and 25 (Suppl. II): II–1–II–163, 1969.

    Google Scholar 

  45. Linzbach AJ : Heart failure from the point of view of quantitative anatomy. Am J Cardiol 5: 370–382, I960.

    Article  Google Scholar 

  46. Hort W : Quantitative morphology and structural dynamics of the myocardium In: Bajusz E, Jasmin G (eds) Methods and Achievements in Experimental Pathology, Vol 5. Basel: Karger, 1971, pp 3–21.

    Google Scholar 

  47. Alpert NR (ed): Myocardial Hypertrophy and Failure, Vol 7. Perspectives in Cardiovascular Research. New York: Raven Press, 1983-

    Google Scholar 

  48. Swynhedauw B, Delcayre C: Biology of cardiac overload. In: Ioachim HL (ed) Pathobiology Annual, Vol 12. New York: Raven Press, 1982, pp 137–183.

    Google Scholar 

  49. Clubb FJ Jr, Bishop SP: Formation of binucleated myocardial cells in the neonatal rat: An index for growth hypertrophy. Lab Invest 50: 571–577, 1984.

    PubMed  Google Scholar 

  50. Grossman W: Cardiac hypertrophy: Useful adaptation or pathologic process? Am J Med 69: 576–584, 1980.

    Article  PubMed  CAS  Google Scholar 

  51. Wikman-Coffelt J, Parmley WW, Mason DR: The cardiac hypertrophy process. Analysis of factors determining pathological vs. physiological development. Circ Res 45: 697–707, 1979.

    PubMed  CAS  Google Scholar 

  52. Scheuer J, Malhotra A, Hirsch C, Capasso J, Schaible TF: Physiologic cardiac hypertrophy corrects contractile protein abnormalities associated with pathologic hypertrophy in rats. J Clin Invest 70: 1300 - 1305, 1982.

    Article  PubMed  CAS  Google Scholar 

  53. Rabinowitz M, Zak R: Biochemical and cellular changes in cardiac hypertrophy. Ann Rev Med 23: 245–262, 1972.

    Article  PubMed  CAS  Google Scholar 

  54. Morkin E: Activation of synthetic processes in cardiac hypertrophy. Circ Res 34 & 35 (Suppl II): 11–37—II–48, 1974.

    Google Scholar 

  55. Cohen J : Role of endocrine factors in the pathogenesis of cardiac hypertrophy. Circ Res 34 & 35 (suppl II): II-49–II-57, 1974.

    Google Scholar 

  56. Schreiber SS, Evans CD, Oratz M, Rothschild MA: Protein synthesis and degradation in cardiac stress. Circ Res 48: 601–611, 1981.

    PubMed  CAS  Google Scholar 

  57. Grossman W, Jones D. McLaurin LP: Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest 56: 56–64, 1975.

    Article  PubMed  CAS  Google Scholar 

  58. Cooper G IV, Kent RL, Uboh CE, Thompson EW, Mariano TA: Hemodynamic versus adrenergic control of cat right ventricular hypertrophy. J Clin Invest 75: 1403–1414, 1985.

    Article  PubMed  CAS  Google Scholar 

  59. Cooper G IV, Kent RL, Uboh CE, Thompson EW, Mariano TA: Hemodynamic versus adrenergic control of cat right ventricular hypertrophy. J Clin Invest 75: 1403–1414, 1985.

    Article  PubMed  CAS  Google Scholar 

  60. Buja LM, Müntz KH, Lipscomb K, Willerson JT: Cardiac hypertrophy in chronic ischemic heart disease. In: Tarazi R (ed) Mechanisms of Left Ventricular Hypertrophy. New York: Raven Press, 1983, pp 287–294.

    Google Scholar 

  61. Braunwald E, Ross Jr J, Sonnenblick EH: Mechanisms of Contraction of the Normal and Failing Heart ( 2nd edition ). Boston: Little, Brown and Company, 1976.

    Google Scholar 

  62. Braunwald E, Historical overview and pathophysiologic considerations. In: Braunwald E, Mock MB, Watson J (eds) Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 3–9.

    Google Scholar 

  63. Schwartz A, Sordahl LA, Entman ML, Allen JC, Reddy YS, Goldstein MA, Luchi RJ, Wyborny LE: Abnormal biochemistry in myocardial failure. Am J Cardiol 32: 407–422, 1973.

    Article  PubMed  CAS  Google Scholar 

  64. Dhalla NS, Das PK, Sharma GP: Subcellular basis of cardiac contractile failure. J Mol Cell Cardiol 10: 363–385, 1978.

    Article  PubMed  CAS  Google Scholar 

  65. Chidsey CA: Calcium metabolism in the normal and failing heart. In: The Myocardium:’ Failure and Infarction. New York: HP Publishing Co, 1975, pp 37–47.

    Google Scholar 

  66. Willerson JT: What is wrong the failing heart? N Engl J Med 307: 243–245, 1982.

    Article  PubMed  CAS  Google Scholar 

  67. Sonnenblick EH, Factor S, Strobeck JE, Capasso JM, Fein F: The pathophysiology of heart failure: The primary role of microvascular hyperactivity and spasm in the development of congestive cardiomyopathies. In: Braunwald E, Mock MB, Watson J (eds) Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 87–97.

    Google Scholar 

  68. Sole MJ: Alterations in sympathetic and parasympathetic neurotransmitter activity. In: Braunwald E, Mock MB, Watson J (eds) Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 101–113.

    Google Scholar 

  69. Bristow MR, Ginsbury R, Minobe W, Cubicciotti RS, Sageman WS, Lurie K, Billingham M, Harrison DC, Stinson EB: Decreased catecholamine sensitivity and β—adrenergic-receptor density in failing human hearts. N Engl J Med 307: 205–211, 1982.

    Article  PubMed  CAS  Google Scholar 

  70. Buja LM, Petty CS: Heart disease, trauma, and death. In: Curran WJ, McGarry AL, Petty CS (eds) Modern Legal Medicine, Psychiatry, and Forensic Science. Philadelphia: FA Davis Company, 1980, pp 187–206.

    Google Scholar 

  71. Yoran C. Covell JW, Ross Jr J: Structural basis for the ascending limb of left ventricular function.Circ Res 32: 297–303, a1973.

    Google Scholar 

  72. Maron BJ, Ferrans VJ: Ultrastructural features of hypertophied human ventricular myocardium. Prog Cardiovasc Dis 11: 207 - 238, 1978.

    Article  Google Scholar 

  73. Dick Mr, Unverferth DV, Baba N: The pattern of myocardial degeneration in nonischemic congestive cardiomyopathy. Human Path 13: 740–744, 1982.

    Google Scholar 

  74. Tarazi RC, Sen S, Fouad FM: Regression of myocardial hypertrophy. In: Braunwald E, Mock MB, Watson J (eds) Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 151–163.

    Google Scholar 

  75. Wynne J, Braunwald E: The cardiomyopathies and myocarditides. In: Braunwald E (ed) Heart Disease: A Textbook of Cardiovascular Medicine, Second Edition Philadelphia: Saunders, 1984, pp 1399–1456.

    Google Scholar 

  76. Goodwin JF : Congestive and hypertrophic cardiomyopathies: A decade of study. Lancet 1: 731–7339, 1970.

    Article  Google Scholar 

  77. Roberts WC, Ferrans VJ: Pathologic anatomy of the cardiomyopathies: Idiopathic dilated and hypertrophic types, infiltrative types, and endomyocardial disease with and without eosinophilia. Human Path 6: 287–342, 1975.

    Article  CAS  Google Scholar 

  78. Davies MJ: The cardiomyopathies: A review of terminology, pathology and pathogenesis. Histopathology 8: 363–393, 1984.

    Article  PubMed  CAS  Google Scholar 

  79. Fuster V, Gersh BJ, Giuliani ER, Tajik AJ, Brandenburg RO, Frye RL: The natural history of idiopathic dilated cardiomyopathy. Am J Cardiol 47: 525–631, 1981.

    Article  PubMed  CAS  Google Scholar 

  80. Clark CE, Henry WL, Epstein SE: Familial prevalence and genetic transmission of idiopathic hypertrophic subaortic stenosis. N Engl J Med 289: 709–714, 1973.

    Article  PubMed  CAS  Google Scholar 

  81. Goodwin JF: ?IHSS. ?HOCM. ?ASH. A plea for unity. Am Heart J 89: 269–277, 1975.

    Google Scholar 

  82. Maron BJ, Roberts WC, McAllister HA, Rosing DR and Epstein SE: Sudden death in young athletes. Circulation 62: 218–229, 1980.

    PubMed  CAS  Google Scholar 

  83. Maron BJ, Roberts WC: Quantitative analysis of cardiac muscle cell disorganization in the ventricular septum of patients with hypertrophic cardiomyopathy. Circulation 59: 689–706, 1979.

    PubMed  CAS  Google Scholar 

  84. Buja LM, Khoi NB, Roberts WC: Clinically significant cardiac amyloidosis: Clinicopathologic findings in 15 patients. Am J Cardiol 26: 394–405, 1970.

    Article  PubMed  CAS  Google Scholar 

  85. Cutler DJ, Isner JM, Bracey AW, Hufnagel CA, Conrad PW, Roberts WC, Kerwin DM, Weintraub AM: Hemochromatosis heart disease: An unempha-sized cause of potentially reversible restrictive cardiomyopathy. Am J Med 69: 923–928, 1980.

    Article  PubMed  CAS  Google Scholar 

  86. Billingham ME, Bristow MR, Mason JW, Joseph LJ: Endomyocardial biopsy. In: Braunwald E, Mock MB, Watson J (eds) Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 237–251.

    Google Scholar 

  87. Nippoldt TB, Edwards WD, Holmes DR Jr, Reeder GS, Hartzler GO, Smith HC: Right ventricular endomyocardial biopsy: Clinicopathologic correlates in 100 consecutive patients. Mayo Clin Proc 57: 407–418, 1982.

    PubMed  CAS  Google Scholar 

  88. Mason JW : Endomyocardial biopsy: The balance of success and failure. Circulation 71: 185-, 1985

    Article  PubMed  CAS  Google Scholar 

  89. Mason JW, Billingham ME, Ricci DR: Treatment of acute inflammatory myocarditis by endomyocardial biopsy. Am J Cardiol 45: 1037–1044, 1980.

    Article  PubMed  CAS  Google Scholar 

  90. O’Connell JB, Robinson JA, Henkin RE, Gunnar RM: Immunosuppressive therapy in patients with congestive cardiomyopathy and myocardial uptake of gallium-67. Circulation 64: 780–786, 1981.

    Article  PubMed  Google Scholar 

  91. Bishop SP: Animal models. In: Braunwald E, Mock MB, Watson J (eds), Congestive Heart Failure: Current Research and Clinical Applications. New York: Grune and Stratton, 1982, pp 125–149.

    Google Scholar 

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© 1989 Kluwer Academic Publishers

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Buja, L.M. (1989). Basic Pathological Processes of the Heart. In: Sperelakis, N. (eds) Physiology and Pathophysiology of the Heart. Developments in Cardiovascular Medicine, vol 90. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0873-7_2

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  • DOI: https://doi.org/10.1007/978-1-4613-0873-7_2

  • Publisher Name: Springer, Boston, MA

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