The Relationship Between The Structure Of Cardiac Muscle Fiber And The Peak Gradient Through Right Ventricle Outflow And Pulmonary Artery

Objective:1. To investigate the variation of ultrastructural organization of myocardiac of tetralogy of Fallot.2. To investigate the mesenchymal variation of myocardium of Tetralogy of Fallot and the relationship between mesenchymal content and the peak gradient through right ventricle outflow and pulmonary artery.Method:23 children with Tetralogy of Fallot from Shandong provincial Hospital and Shandong University Qilu Hospital were studied. Divided them into three groups according to age: TOF-â… : below 1-year-old 7 children, TOF-â…¡: 1 year to 3-year-old 8children, and TOF-â…¢: above 3-year-old 8children. The myocardial tissues were taken intraoperatively from the right ventricular outflow tract. The tissues of group TOF-â… were divided into two shares, One share were prepared for ultrathin electron microscopic section to scanning the variation of ultrastructural organization of myocardia, another share and other group's tissues were prepared for paraffin section to observe in light microscope to survey and evaluate the mesenchymal variation of myocardia in Tetralogy of Fallot, to investigate the relationship between mesenchymal content and transthoracic echocardiography.Tissues from autopsy of 21 children died without cardiovascular disease and collagen system disease were used as control. Divided them into three groups according to age: control-â… : below 1-year-old 7 cases, control-â…¡: 1 year to 3-year-old 7 cases, and control-â…¢: above 3-year-old 7 cases.Result: 1. In study 1, under transmission electron microscope, we find the variation of ultrastructural organization of myocardiac is obvious, with cardiac muscle fiber arrangement disorderly, with loss of the normal parallel, little chondriosome increasing obviously, variety degree of hyperplasia. Numbers of midochondria can be found under the sarcolemma.2. The degree of fibrosis of cardiac muscle becomes increasing serious along with the growth of the patients an presents a positive correlation between the degree of fibrosis of cardiac muscle and the peak gradient through right ventricle outflow and pulmonary artery.Conclusion: The surgical repair of tetralogy of Fallot ought to be operated before one-year-old especially for the cases with high peak gradient through right ventricle outflow and pulmonary artery.