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- Title
Microvascular Rarefaction and Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy.
- Authors
Tian, Hongwei; Yang, Chengzhi; Song, Yunhu; Wang, Hongyue; Yuan, Jiansong; Cui, Jingang; Liu, Shengwen; Hu, Fenghuan; Yang, Weixian; Jiang, Xiaowei; Qiao, Shubin
- Abstract
<bold><italic>Background:</italic></bold> Hypertrophic obstructive cardiomyopathy (HOCM) is a myocardial disease characterized by fibrosis and microvascular ischemia. Microvessels play a critical role in myocardial fibrosis in HOCM. However, it remains unclear whether or not myocardial fibrosis is associated with microvascular density (MVD) changes. <bold><italic>Objective:</italic></bold> The aim of the present study was to investigate whether a reduction in MVD is related to myocardial fibrosis in HOCM cardiac samples. <bold><italic>Methods:</italic></bold> We analyzed MVD and fibrosis in myectomy left ventricular (LV) septal wall specimens from 53 HOCM patients. Control myocardium from the LV septal wall was collected at autopsy of 9 individuals who died of noncardiac causes. <bold><italic>Results:</italic></bold> The fibrosis ratio (% area) in HOCM was higher and the MVD was lower than that in control subjects (i.e., 12.7 ± 10.0 vs. 4.0 ± 1.4%, <italic>p</italic> = 0.012, and 480.9 ± 206.7 vs. 1,425 ± 221/mm2, <italic>p</italic> < 0.001). Patients with mild fibrosis had a higher MVD than patients with moderate fibrosis (i.e., 568.2 ± 214.8 vs. 403.2 ± 167.8/mm2, <italic>p</italic> = 0.006) and patients with severe fibrosis (i.e., 568.2 ± 214.8 vs. 378.6 ± 154.0/mm2, <italic>p</italic> = 0.024). Furthermore, a significant negative correlation was found between myocardial fibrosis and MVD in HOCM patients (<italic>r</italic> = –0.40, <italic>p</italic> = 0.003), which was also found in mild fibrosis (<italic>r</italic> = –0.40, <italic>p</italic> = 0.043), moderate fibrosis (<italic>r</italic> = –0.50, <italic>p</italic> = 0.024), and severe fibrosis (<italic>r</italic> = –0.24, <italic>p</italic> = 0.61), although no significant differences were observed in severe fibrosis. Additionally, we demonstrated that late gadolinium enhancement was negatively correlated with MVD (<italic>r</italic> = –0.37, <italic>p</italic> = 0.03) and positively correlated with fibrosis (<italic>r</italic> = 0.44, <italic>p</italic> = 0.01).<bold><italic> Conclusion:</italic></bold> HOCM patients had a higher myocardial fibrosis ratio and a lower MVD. The severity of myocardial fibrosis was negatively correlated with MVD in HOCM. These findings showed that a reduced MVD may contribute to myocardial fibrosis in HOCM.
- Subjects
HYPERTROPHIC cardiomyopathy; FIBROSIS; HEART fibrosis; CARDIOMYOPATHIES; INVERSE relationships (Mathematics)
- Publication
Cardiology, 2018, Vol 141, Issue 4, p202
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000493005