Myocarditis and arrhythmia: a clinico-pathological study of conduction system based on serial section in 65 cases.
Myocarditis and arrhythmia: a clinico-pathological study of conduction system based on serial section in 65 cases.
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心肌炎与心律失常：基于连续切片的传导系统65例临床病理研究。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
T. Otsuka
中科院分区：
文献类型：
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作者：
S. Inoue;F. Shinohara;T. Sakai;H. Niitani;T. Saito;J. Hiromoto;T. Otsuka
我们研究了7120例尸检样本中65例经证实活跃或治愈的心肌炎及相关疾病的传导系统。为此，我们采用列夫法制备了连续切片。病理诊断为特发性急性心肌炎（5例）、巨细胞性心肌炎（3例）、慢性心肌炎（13例）、愈合性心肌炎（22例）、结节病（4例）、胶原或自身免疫性疾病（13例）、恶病质并发症（5例）。在所有尸检病例中，Fiedler心肌炎仅1例，而扩张型心肌病30例中有19例，病窦综合征25例中有15例。传导系统病变分为两组。在以心律失常为主要表现的老年病例中，窦房结、房肌和房室结受累并伴有心包炎。在以心力衰竭为主的年轻患者中，RBB、LBB和浦肯野纤维因心内膜炎而受损。组织学上，前者为间质性心肌炎，后者为实质性心肌炎。
We studied the conduction system of 65 cases of proven active or healed myocarditis and related diseases among 7120 autopsy samples. For this purpose, we prepared serial sections by Lev's method. The pathological diagnoses were idiopathic acute myocarditis (5), giant cell myocarditis (3), chronic myocarditis (13), healed myocarditis (22), sarcoidosis (4), collagen or autoimmune disease (13) and complication of cachexia (5). Among all the autopsy cases, Fiedler's myocarditis was found in only one case, but myocarditis was revealed in 19 out of 30 cases of dilated cardiomyopathy, and 15 out of 25 cases of sick sinus syndrome. Conduction system lesions were divided into two groups. In older cases manifesting mainly arrhythmia, the SA node, atrial muscle and AV node were involved concomitantly with perimyocarditis. In younger cases mainly showing heart failure, the RBB, LBB and Purkinje fibers were damaged by endomyocarditis. Histologically, interstitial myocarditis was observed in the former group and parenchymatous myocarditis in the latter.