Pivotal Karyometric Measurements in Different Types of Cardiomyopathic Morphology: Study of Hearts Explanted From Transplant Recipients J. Noz ˙ yn ´ ski, M. Zakliczyn ´ ski, D. Konecka-Mrówka, S. Z ˙ eglen ´ , R. Przybylski, M. Zembala, D. Lange, E. Zembala-Noz ˙ yn ´ ska, T. Me ¸ cik-Kronenberg, and K. Da ˛ brówka ABSTRACT Background. Morphometric studies based on the measurement of cardiocyte nuclei have focused on progressive hypertrophy rather than shape, which is a deciding factor for the diagnosis of hypertrophy in myocardial diseases. The aim of this research was to demonstrate how the digital morphology of cardiocyte nuclei change correlated with the type of myocardial pathology. Materials and Methods. The study groups encompassed 7 hearts with dilated cardio- myopathy (DCM) and 8 hearts with ischemic heart disease (IHD) which were explanted. A comparative group consisting of myocardial hypertrophy was contrasted with a control group of donor heart fragments. Cardiocyte nuclei were evaluated morphometrically on histologic slides. We calculated the nuclear area, length, breadth, perimeter, roundness, elongation, fullness factors, and nuclear chromatin mean gray level. The results were subjected to discriminant analysis. Results. All karyometric measurements analyzed by backward discriminant analysis showed only 2 powerful factors: nuclear breadth and chromatin mean gray level. The Mahalanobis distance showed the proximity of control and hypertrophy groups, whereas differences between IHD and DCM were nonsignificant. Conclusion. The lack of karyometric differences between IHD and DCM suggested a common morphologic response for long-lasting progressive injury. The main morphologic differences were dependent on nuclear chromatin activity/stainability and nuclear breadth, suggesting darker and thinned nuclei in normal and adaptative stages and irregular brighter nuclei in cardiomyopathies. I NDICATIONS for and the role of endomyocardial bi- opsy in the diagnosis of the cardiomyopathy have been undergoing reevaluation recently. 1 The main limitations of the method are nonspecificity of the microscopic chan- ges, 2 and the variations in the interpretation of histological samples, 3 especially when considering histologic structure or definition of cardiocyte cytopathology. Quantitative his- tology presently offers an objective assessment of typical changes, mainly fibrosis as described by Hess et al, 4 whereas the cardiocyte nuclear changes are still evaluated semiquan- titatively or rather descriptively. The same approach was used in the archival work of Baandrup and Olsen analyzing cardiocyte diameters, cellular densities, and volume frac- tions of collagen morphometrically, whereas cardiocyte nuclear assessments were made only semiquantitatively. 5 Our previous semiquantitative and quantitative studies on myocardial biopsies of transplanted hearts indicated the dependence of cardiocyte nuclei on the immunosuppressive therapy, 6,7 on the changes of karyometric values during acute rejection, 8 and on morphometric, especially karyo- From the Silesian Centre for Heart Diseases (J.N., M.Za., D.K.-M., S.Z ˙ ., R.P., M.Ze.), Zabrze, Poland; the Department of Tumor Pathology (D.L., E.Z.-N.), Comprehensive Cancer Centre, M. Sklodowska-Curie Memorial Institute Branch, Gliwice, Po- land; and the I st Department of Pathology in Zabrze (T.M.-K., K.D.), Medical University of Silesia, Poland. Address reprint requests to M. Zakliczynski, Silesian Center for Heart Disease, Szpitalna 2, 41-800 Zabrze, Poland. E-mail: zaklimed@onet.pl © 2009 by Elsevier Inc. All rights reserved. 0041-1345/09/$–see front matter 360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2009.07.067 Transplantation Proceedings, 41, 3179 –3184 (2009) 3179