Morphogenesis of a Neuroleptic Cardiomyopathy:A Morphometric Study

Abstract

Aim: A comparative morphometric study of heart condition on various organizational levels (organ, tissue, and cellular one) in each clinical stage of neuroleptic cardiomyopathy.

Methods and results: Morphometric methods of research were used which meet modern requirements of the evidence-based medicine. For analysis of data from organometry of heart an own original method was used. For this analysis the outer volume of heart without atria (V) was determined and two relative parameters (both in percent) were calculated: 1) Cv - coefficient of volume, this coefficient shows a part of the total volume of heart (without atria), and this part falls on the volume of cavities of ventricles; and 2) Cl - coefficient of the left ventricle, this coefficient shows the volume size of the left ventricle with respect to the total volume of both ventricles. In addition, two other parameters were calculated which use a gravimetric characteristic of the heart (m): mass-volume ratio (MVR) and index of density of myocardium (IDM).

It was found that on the organ level the process of cardiac remodeling ends during the latent stage of the disease. Progression of myocardial dysfunction is connected with changes of myocardium microstructure.

The studied micromorphometric parameters describe the condition of three structural components of myocardium (vasculature, intercellular matrix, and parenchyma). Such parameters as zone of pericapillary diffusion (ZPD), Kernogan index (KI), SPR, RIE were calculated. Karyometry and cytometry of cardiomyocytes (CMCs) were performed, the specific volumes of hypertrophied CMCs (SVHC), of atrophied ones (SVAC), and – by the method of polarization microscopy – the specific volume of dystrophic ones (SVDC) were determined.

In the latent stage the microcirculatory disorders prevail. In the full-scale stage the damages of intercellular matrix come to the forefront. For the terminal stage the atrophic and dystrophic-degenerative changes of cardiomyocytes are characteristic.

Conclusion: In the course of morphogenesis of a neuroleptic cardiomyopathy a certain staging of clinical manifestations of the disease is observed; this staging corresponds to an observed cardiac remodeling on the organ level and to an observed chain of interconnected pathologic shifts in all microstructures of myocardium.