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Coronary artery occlusion and a variety of inflammatory disorders are followed by focal or segmental areas of fibrous scarring. The causes of interstitial fibrosis are less clear. Variable but sometimes dense interstitial fibrosis is seen in dilated cardiomyopathy.1 Some reports suggest that interstitial fibrosis is also increased in non-infarcted myocardium from hearts with ischaemic scars.2 Because of current interest in the pathophysiology of ventricular dilatation, we compared the interstitial collagen content of the left and right ventricles in dilated and undilated hearts of subjects without significant coronary artery occlusion. Our hypothesis was that we would find histological evidence of increased interstitial collagen content in dilated hearts.
Forty four hearts were selected from approximately 500 necropsies of adults who died in the community or at Southampton University Hospitals over a six month period. For case selection mitral valve circumference was measured. Hearts with a mitral valve circumference > 110 mm were provisionally assigned to the test (dilated) group and those < 110 mm to the control group. Five criteria were then considered. If any of these applied to the hearts from either the test or the control group, they were excluded from further study. These were (1) a clinical history of ischaemic heart disease; (2) macroscopic evidence of old or recent ischaemic heart disease; (3) any stenosis > 50% of the external diameter of a major epicardial coronary artery; (4) valvar or congenital cardiac disease apart from mild thickening of the anterior mitral valve leaflet; and …