Some ultrastructural features of the myocardial cells in the hypertrophied human papillary muscle.

An ultrastructural study using various electron microscopical techniques has been conducted on biopsy material from the hypertrophied papillary muscle of the human heart. About 75% of the myocardial cells were classified as hypertrophic with diameters ranging from 15 micron to 53 micron. The increased cell diameter appeared to be the result of an elevated amount of mitochondria and contractile material. The hypertrophied myocytes displayed a general ultrastructural organization in many ways similar to that of the normal sized myocytes. However, the former cells were characterized by focal deposits of excess laminar coat material and abnormal Z-band patterns as well as of multiple intercalated discs. The preferential sites for the production of new sarcomere elements appeared to be in the subsarcolemmal and intercalated disc regions. Adjacent myocardial cells were interconnected by collagen bundles, and, by an elaborate collagen-fibril-microthread-granule lattice. The surface folds were linked to each other by surface cables, which probably constituted a separate category of extracellular material of unknown function. Intramembranous particles were abundant in the sarcolemma proper but scarce in the membranes of the sarcoplasmic vesicles. Such particles were also observed in the lipofuscin granular membrane and in the membranes surrounding the lipid droplets. A framework of transverse cytoskeletal filaments interconnected the Z-bands of adjacent myofibrils and anchored the contractile material to the sarcolemma as well as to the nucleus. A large and lobulated nucleus containing well developed nucleoli together with an abundance of sarcoplasmic free and membrane-attached ribosomes, were interpreted as morphological signs of enhanced synthetic activity in the hypertrophied cell. Degenerative phenomena on the other hand were confined to lysosomal degeneration of worn-out cell constituents that were manifested by the numerous lysosomes and aggregates of lipofuscin granules. Abnormal Z-band patterns as seen in the present material were interpreted as an initial stage in the formation of new contractile elements.