BACKGROUND: Although myocardial fibrosis plays an important role in the progression of heart failure (HF), its prognostic impact still remains to be clarified. METHODS AND RESULTS: A total of 172 consecutive patients with chronic HF, who underwent cardiac catheterization and endomyocardial biopsy between January 2001 and September 2008, were examined. They were divided into 2 groups: HF with preserved ejection fraction (HFPEF; left ventricular ejection fraction [LVEF] ≥ 50%, n=81); and HF with reduced LVEF (HFREF; LVEF < 50%, n=91). The collagen volume fraction (CVF) in biopsy samples was calculated and its prognostic impact examined. Mean follow-up in the HFPEF and the HFREF groups was 41 ± 33 months and 41 ± 26 months, respectively. Although CVF was similar between the 2 groups (1.83 ± 1.54% vs. 2.07 ± 2.35%), CVF was significantly correlated with LV end-diastolic pressure in the HFREF group but not in the HFPEF group. When HF stage was adjusted, the long-term prognosis was comparable between the 2 groups. When the patients were divided into 2 groups according to median CVF, however, severe fibrosis was a significant predictor for all-cause death (P=0.014) and cardiac events (P=0.02) in the HFREF, but not in the HFPEF group. CONCLUSIONS: Myocardial fibrosis evaluated on biopsy samples is a useful indicator for long-term survival, suggesting that it may be an important therapeutic target as well.
BACKGROUND: Although myocardial fibrosis plays an important role in the progression of heart failure (HF), its prognostic impact still remains to be clarified. METHODS AND RESULTS: A total of 172 consecutive patients with chronic HF, who underwent cardiac catheterization and endomyocardial biopsy between January 2001 and September 2008, were examined. They were divided into 2 groups: HF with preserved ejection fraction (HFPEF; left ventricular ejection fraction [LVEF] ≥ 50%, n=81); and HF with reduced LVEF (HFREF; LVEF < 50%, n=91). The collagen volume fraction (CVF) in biopsy samples was calculated and its prognostic impact examined. Mean follow-up in the HFPEF and the HFREF groups was 41 ± 33 months and 41 ± 26 months, respectively. Although CVF was similar between the 2 groups (1.83 ± 1.54% vs. 2.07 ± 2.35%), CVF was significantly correlated with LV end-diastolic pressure in the HFREF group but not in the HFPEF group. When HF stage was adjusted, the long-term prognosis was comparable between the 2 groups. When the patients were divided into 2 groups according to median CVF, however, severe fibrosis was a significant predictor for all-cause death (P=0.014) and cardiac events (P=0.02) in the HFREF, but not in the HFPEF group. CONCLUSIONS:Myocardial fibrosis evaluated on biopsy samples is a useful indicator for long-term survival, suggesting that it may be an important therapeutic target as well.
Authors: Michael R Zile; Catalin F Baicu; John S Ikonomidis; Robert E Stroud; Paul J Nietert; Amy D Bradshaw; Rebecca Slater; Bradley M Palmer; Peter Van Buren; Markus Meyer; Margaret M Redfield; David A Bull; Henk L Granzier; Martin M LeWinter Journal: Circulation Date: 2015-01-30 Impact factor: 29.690
Authors: Selma F Mohammed; Saad Hussain; Sultan A Mirzoyev; William D Edwards; Joseph J Maleszewski; Margaret M Redfield Journal: Circulation Date: 2014-12-31 Impact factor: 29.690
Authors: G Youcef; A Olivier; N Nicot; A Muller; C Deng; C Labat; R Fay; R-M Rodriguez-Guéant; C Leroy; F Jaisser; F Zannad; P Lacolley; L Vallar; A Pizard Journal: Br J Pharmacol Date: 2016-04-26 Impact factor: 8.739