FATTY CHANGE IN PAPILLARY HEART MUSCLE AND IN ITS ARTERIOLES

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Abstract
The fatty change in the anterior papillary muscle of the left ventricular heart was examined in histological sections stained with Oil‐Red‐O. The material comprised 228 hospitalized patients aged over 20 years, who had died of various diseases, and 34 subjects, also aged over 20 years, who had suffered a sudden, violent death. They were all subjected to a complete autopsy. The following findings were recorded: 1. The parenchymal fatty change was most pronounced at the tip of the papillary muscle and over the subendocardial region. 2. The arteriolar fatty change was most pronounced in the media. Adventitial fatty change was slight, intimal fatty change being minimal. 3. The more pronounced the parenchymal fatty change, the more pronounced and frequent the arteriolar fatty change. 4. Cases of parenchymal and arteriolar fatty change tended to accumulate in identical disease groups. 5. An analysis by age groups revealed that coronary atherosclerosis and the fatty change of the parenchyma and arteriolar media of the papillary muscle in men were correlated. In women, the fatty change of the parenchyma and arteriolar media increased sharply in the age group 45–53. It is possible that this may be a result of the change in lipid metabolism which takes place in the climacteric phase, since in moderate and severe coronary atherosclerosis the corresponding sharp rise did not take place until in the age group 54–62, including women in the post‐climacteric phase. 6. In diseases correlated with coronary atherosclerosis (arterial hypertension, diabetes, cholelithiasis) the incidence of fatty change of parenchyma and arteriolar media in the different age groups and the degrees of severity of coronary atherosclerosis, were higher than in the hospital series in general. 7. In mild coronary atherosclerosis the fatty change of the arteriolar media was almost as frequent as in moderate and severe coronary atherosclerosis. 8. In subjects who had died a sudden, violent death, the incidence of fatty change of the parenchyma and arteriolar media was unexpectedly high. This was especially true in the group of patients at ages over 50, which suggests that the fatty change, at least in a mild form, may be relatively common among the general population.

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