Which histopathologic finding is associated with systolic dysfunction?

Which histopathologic finding is associated with systolic dysfunction?

• A. Thinner, elongated cardiomyocytes and fibrosis
• B. Cardiomyocyte hypertrophy, inflammation, & fibrosis
• C. Increase in adipocyte infiltration and necrosis
• D. Normal cardiomyocyte morphology with interstitial edema

Answer: (A)

Systolic dysfunction stems from remodeling of the ventricle in which dilation stretches and thins the wall while fibrous tissue replaces some of the damaged myocardium. The chronic volume overload leads to cardiomyocyte elongation as cells are pulled apart by the enlarged chamber, and fibrosis develops as part of the scar formation that accompanies ongoing injury. This combination—thinner, elongated cardiomyocytes with fibrosis—best fits the pattern of structural change seen with reduced contractility and lower ejection fraction. Other patterns point to different conditions: hypertrophy with inflammation would be more typical of hypertrophic or inflammatory cardiomyopathies; adipocyte infiltration and necrosis aren’t characteristic of classic systolic failure; normal cell morphology with edema reflects acute congestion rather than chronic remodeling.

Systolic dysfunction stems from remodeling of the ventricle in which dilation stretches and thins the wall while fibrous tissue replaces some of the damaged myocardium. The chronic volume overload leads to cardiomyocyte elongation as cells are pulled apart by the enlarged chamber, and fibrosis develops as part of the scar formation that accompanies ongoing injury. This combination—thinner, elongated cardiomyocytes with fibrosis—best fits the pattern of structural change seen with reduced contractility and lower ejection fraction.

Other patterns point to different conditions: hypertrophy with inflammation would be more typical of hypertrophic or inflammatory cardiomyopathies; adipocyte infiltration and necrosis aren’t characteristic of classic systolic failure; normal cell morphology with edema reflects acute congestion rather than chronic remodeling.