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Myocardial collagen type I and impaired left ventricular function under exercise in hypertrophic cardiomyopathy

M Mundhenke1, B Schwartzkopff, P Stark

  • 1Department of Cardiology, Pulmology and Angiology, Medical School of the Heinrich Heine University, Düsseldorf, Germany.

The Thoracic and Cardiovascular Surgeon
|August 8, 2002
PubMed

Insights

Increased collagen subtype I in hypertrophic cardiomyopathy predicts exercise-induced systolic and diastolic dysfunction even after successful transaortic subvalvular myectomy surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Transaortic subvalvular myectomy (TSM) improves symptoms in hypertrophic obstructive cardiomyopathy (HOCM) but doesn't fully restore cardiac function.
  • Abnormal myocardial collagen structure may indicate persistent cardiac dysfunction post-surgery.

Purpose of the Study:

  • To investigate the relationship between myocardial collagen structure and cardiac function in HOCM patients post-TSM.

Main Methods:

  • Assessed myectomy specimens for myocytic diameter and collagen subtype I (Coll I(prod)).
  • Evaluated cardiac function using exercise radionuclide angiocardiography (ejection fraction) and right heart catheterization (pulmonary capillary wedge pressure, cardiac index).

Main Results:

  • Collagen I(prod) inversely correlated with ejection fraction under exercise (r = -0.64; p = 0.05).
  • Collagen I(prod) strongly correlated with increased pulmonary capillary wedge pressure under exercise (r = 0.90; p = 0.001).
  • Cardiac index improved post-surgery, but ejection fraction did not significantly increase with exercise.

Conclusions:

  • Elevated collagen subtype I predicts both diastolic and systolic dysfunction during exercise in HOCM patients post-TSM.
  • Myocardial collagen structure is a key factor in residual cardiac dysfunction after surgical intervention.
Abstract

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