МОРФОЛОГИЯ ЭЛЕКТРОФИЗИОЛОГИЧЕСКИХ НАРУШЕНИЙ МИОКАРДА ПРИ ПОСТИНФАРКТНОЙ АНЕВРИЗМЕ И ЖЕЛУДОЧКОВОЙ ТАХИКАРДИИ

Abstract

Aim . To study morphology of the left ventricle (LV) myocardium in zones with disordered conduction of electrical potential in patients with post infarction aneurysm of the heart and ventricular tachycardia. Material and methods. The microscopic and morphometric investigations performed of 78 fragments of LV myocardium, obtained during LV reconstruction from zones with different electrical conductivity, from 19 patients with post infarction LV remodeling and chronic heart failure. For electrical conductivity all patients underwent electrophysiological study of the heart. In the zones with normal conduction (1 group) the value of electrical potential was more than 1,5 mV, in transient zone (2 group) — 0,5-1,5 mV, in “electrical scar” zone — less than 0,5 mV (3 group). The zone with zero value of electrical potential got to the 4th group. Results. In transient zone of myocardium pieces and “electrical scar” zone, comparing to those from normal electrical potential, there were more significant sclerosis of endocardium and myocardium, atrophy and degeneration of cardiomyocytes. In “electrical scar” zone there was more significant value of these changes than in transitory zone. Areas of myocardium with zero value of the potential differed from the zones with normal and low values of electrical potential by more significant replacement of myocardium by fat tissue. Conclusion. Transition from normal electrical potential to electrical scar do determine the severity of endocardial fibrosis, and myocardial lipomathosis, degeneration of cardiomyocytes