The Left Ventricular Myocardium in Hypoplastic Left Heart Syndrome.

The Left Ventricular Myocardium in Hypoplastic Left Heart Syndrome.
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DOI:
10.3390/jcdd9080279
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发表时间:
2022-08-19
影响因子:
2.4
通讯作者:
--
中科院分区:
医学3区
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--
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左心发育不良综合征(HLHS)是一个适用于严重先天性心脏畸形的集合术语,其特征是主要影响左心室、相关瓣膜和升主动脉的异常组合。尽管在临床实践中,HLHS通常根据二尖瓣和主动脉(左侧)瓣膜的通畅性进行亚分类,但也可以根据左心室形态将HLHS全面分类为定义的亚组。在这里,我们讨论了已发表的人类为基础的研究,在HLHS心室心肌,评估现有的证据是否符合这个心室形态的概念。具体来说,我们强调了组织学研究的结果,表明心肌细胞的外观可以根据HLHS的亚组而不同。此外,我们还讨论了内膜弹力纤维增生症(EFE)的组织学表现,这是HLHS的一个特定亚组的共同特征。最后,我们建议调查,理想情况下,应进行HLHS心肌组织在HLHS发展的早期阶段,以确定生物学途径,并帮助理解HLHS病因。
Hypoplastic left heart syndrome (HLHS) is a collective term applied to severe congenital cardiac malformations, characterised by a combination of abnormalities mainly affecting the left ventricle, associated valves, and ascending aorta. Although in clinical practice HLHS is usually sub-categorised based on the patency of the mitral and aortic (left-sided) valves, it is also possible to comprehensively categorise HLHS into defined sub-groups based on the left ventricular morphology. Here, we discuss the published human-based studies of the ventricular myocardium in HLHS, evaluating whether the available evidence is in keeping with this ventricular morphology concept. Specifically, we highlight results from histological studies, indicating that the appearance of cardiomyocytes can be different based on the sub-group of HLHS. In addition, we discuss the histological appearances of endocardial fibroelastosis (EFE), which is a common feature of one specific sub-group of HLHS. Lastly, we suggest investigations that should ideally be undertaken using HLHS myocardial tissues at early stages of HLHS development to identify biological pathways and aid the understanding of HLHS aetiology.
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