Myocardial morphology in hypertrophic cardiomyopathy: the current state of the problem

Abstract

The objective. Based on the modern sources of scientific data to analyze the morphological features of the myocardium in hypertrophic cardiomyopathy. The paper presents a literature review on current views on the features of structural remodeling of the left ventricular myocardium in patients with hypertrophic cardiomyopathy, as well as the most common classifications of this pathology. The emphasis is made on the problem of the interrelation of myocardial disarray and fibrosis. The “small vessel disease” is an important pathogenetic link in the development of heart failure, which enhances the relation between disorder of myocardial histoarchitectonics and progressive cardiac ischemia in hypertrophic cardiomyopathy. Conclusions. Notwithstanding the numerous research data on hypertrophic cardiomyopathy, no consensus among the authors regarding the etiology and pathogenesis of hypertrophic cardiomyopathy exists to date. Controversial data on the interrelation and sequence of disarray, myocardial hypertrophy, interstitial fibrosis, changes in the microvasculature and structural changes of the mitral valve in patients with hypertrophic cardiomyopathy hamper the search for adequate etiotropic treatment. Polymorphism of clinical and morphological manifestations of hypertrophic cardiomyopathy requires collaborative efforts to study the disease by cardiologists and pathologists.