Journal of Advances in Medicine and Medical Research

Background: Age-related myocardial and vascular remodelling is recognised, but autopsy-based morphometric evidence across narrowly defined age groups in chronic ischaemic heart disease remains limited.

Aim: To characterise pathomorphological and morphometric changes in myocardial structures across age groups among individuals who died from atherosclerotic cardiosclerosis.

Methods: Left ventricular and interventricular septal tissue from 104 autopsy cases was examined across five age brackets: 51–55, 56–59, 60–65, 66–70, and over 70 years. Histological sections were stained with haematoxylin-eosin, Van Gieson’s, and Weigert’s methods, and morphometry was performed using Avtandilov’s point-counting method.

Results: Dystrophic, necrobiotic, fibrotic, and oedematous changes became more pronounced with age. Mean cardiomyocyte size was 26.7±0.07 μm in the younger group, 28.6±0.08 μm in the middle-aged group, and 21.7±0.02 μm in the elderly group. Muscle-tissue area declined from 63.7% at 51–55 years to 52.2% in those over 70 years, while fibrous-tissue area peaked at 39.3% at 60–65 years. Intramyocardial vessel-wall area increased from 9.8±0.25% to 12.7±0.23%, whereas vascular lumen area decreased from 5.2±0.19% to 4.2±0.20%.

Conclusion: The findings demonstrate age-associated differences in cardiomyocyte dimensions, fibrous-tissue representation, and intramyocardial vascular remodelling within chronic ischaemic heart disease. These results should be interpreted within this disease-only autopsy population because no non-ischaemic control group was included.