Figure 2

Weight/size paradox in congestive heart failure. The slippage of myocardial cell to explain a normal wall and myocellular size despite a heavy cardiac weight [A], does not consider the myofibrillar bridging between myocells and fibrillar collagen connections. Slippage of myocells, capable to reduce for instance a 3 cm cardiac wall in 1.5 one, should imply an extensive destruction of all interstitial structures [vessels, including lymphatics, and nerves] and consequent widespread tissue damage never seen in this condition. Even a neogenesis of the myocardial cell was never observed. Only once in an endomyocardial biopsy at a previous site of sampling in a transplanted heart, we had the opportunity to see new myocells forming a focus of small elements assuming the aspect of atrio-ventricular node [B, C]. Just to emphasize that a neogenesis when exists can be seen, apparently without integration in the functioning myocardium.