A COMPARISON OF THE PATHOLOGICAL SPECTRUM OF HYPERTENSIVE, DIABETIC, AND HYPERTENSIVE-DIABETIC HEART-DISEASE
A COMPARISON OF THE PATHOLOGICAL SPECTRUM OF HYPERTENSIVE, DIABETIC, AND HYPERTENSIVE-DIABETIC HEART-DISEASE
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DOI：
10.1161/01.cir.82.3.848
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发表时间：
1990-09-01
期刊：
影响因子：
37.8
通讯作者：
FACTOR, SM
中科院分区：
文献类型：
--
作者：
VANHOEVEN, KH;FACTOR, SM
对67例高血压、糖尿病和/或合并高血压、糖尿病患者尸检心脏进行了显微镜和组织化学检查，并测定了纤维化程度。在心脏重量、间质纤维化、替代纤维化和血管周围纤维化方面，两组之间存在显著差异。高血压合并糖尿病患者的平均心脏重量显著大于高血压患者和糖尿病患者。两组之间的微观纤维化量增加，高血压心脏最低，糖尿病心脏中等，高血压-糖尿病心脏最高。在糖尿病和高血压-糖尿病患者中，总纤维化与心脏重量相关，在充血性心力衰竭患者中显著更大，他们中的大多数都有高血压和糖尿病病史。纤维化的显微镜分级与心肌组织中每毫克总非胶原蛋白中胶原含量的定量组织化学测定显著相关(p<0.01)。心肌纤维化可能导致高血压-糖尿病心肌病的典型舒张期功能障碍，充血性心力衰竭是常见的后遗症。讨论了高血压在重症糖尿病心脏病发病机制中的重要性。
The hearts obtained at autopsy of 67 patients with hypertension, diabetes mellitus, or both were examined microscopically and histochemically, and the amount of fibrosis was determined. Significant differences in heart weight, interstitial fibrosis, replacement fibrosis, and perivascular fibrosis were found among the groups. The mean heart weight of the hypertensive-diabetic patients was significantly greater than that of the hypertensive patients and the diabetic patients. The amount of microscopic fibrosis increased between the groups, the lowest in hypertensive hearts, midrange in diabetic hearts, and highest in hypertensive-diabetic hearts. Total fibrosis correlated with heart weight among diabetic and hypertensive-diabetic patients and was significantly greater among patients with congestive heart failure, most of whom had histories of both hypertension and diabetes. The microscopic grade of fibrosis correlated significantly (p less than 0.01) with a quantitative, histochemical determination of the amount of collagen per milligram of total noncollagenous protein in the heart tissue. Myocardial fibrosis may contribute to the diastolic dysfunction typical of hypertensive-diabetic cardiomyopathy, in which congestive heart failure is a common sequela. The importance of hypertension in the pathogenesis of severe diabetic heart disease is discussed.