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Journal of Electron Microscopy Advance Access published online on September 30, 2009
Journal of Electron Microscopy, doi:10.1093/jmicro/dfp048
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© The Author 2009. Published by Oxford University Press [on behalf of Japanese Society of Microscopy]. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Autophagy in transition from hypertrophic cardiomyopathy to heart failure

Anna Fidzianska1, Zofia T. Bilinska2,*, Ewa Walczak3, Adam Witkowski4 and Lidia Chojnowska2

1 Neuromuscular Unit, MRC, Polish Academy of Science, Warsaw, Poland; Pawinskiego 5, Warszawa
2 1st Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
3 Department of Pathology, Institute of Rheumatology, Spartanska 1, Warszawa, Poland
4 Catheterization Laboratory, Institute of Cardiology, Alpejska 42, Warszawa, Poland

* To whom correspondence should be addressed. E-mail: zbilinska{at}ikard.pl

Endomyocardial biopsy of a patient in transition stage from hypertrophic cardiomyopathy to heart failure was investigated. The tissue showed hypertrophy, atrophy of myocytes and an increased amount of fibrosis. In addition, numerous cardiomyocytes revealed ubiquitin positive inclusions. Ultrastructural analysis indicated that cardiomyocytes contained typical autophagic vacuoles including mitochondria, glycogen granules, degraded remnants and myelin structures. The most obvious ultrastructural finding was the presence of amorphous plaques and tubulofilamentous inclusions. Such ultrastructural abnormalities allow us to conclude that degeneration of myocardial cells by autophagy mechanisms leads to cardiomyocyte death, loss and heart failure.

Keywords     hypertrophic cardiomyopathy, heart failure, autophagy, endomyocardial biopsy, pathology

Received      2 July 2009, accepted 7 September 2009


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