Alterations of anionic molecular organization in basement membrane ultrastructures of human myocardial cells and capillaries in diseased state

Electron microscopic cytochemical investigation of anionic binding sites in the cardiac basement membranes was carried out in 34 patients with various forms of chronic heart disease. In the diseased state, pathological alterations of basement membranes ultrastructures associated with perturbations of anionic molecular organization in the abnormal membranes of myocardial cells and capillaries were consistently demonstrated, predominantly in patients suffering from long-standing heart failure, chronic uremia and clinically severe cyanosis of long duration. Thus, it is postulated that unfavorable metabolic process, resulting from cellular hypertrophy, uremic toxemia and chronic hypoxemia play a relevant role in the initiation of basement membrane changes in the diseased heart. Membranes act as a molecular sieve permitting molecular passage depending on their size and the charge. Pathological changes of basement membranes at the molecular level can alter the membrane's selective permeability of myocardial cells and capillaries. This suggests an important pathogenetic mechanism responsible for progressive degeneration of myocardial tissue and myocardial dysfunction in a wide variety of disease processes affecting the myocardium.