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Myocardial structure and function differ in systolic and diastolic heart failure

Loek van Heerebeek1, Attila Borbély, Hans W M Niessen

  • 1Department of Physiology, Institute for Cardiovascular Research, VU Medical Center, Amsterdam, The Netherlands.

Circulation
|April 19, 2006
PubMed

Insights

Systolic heart failure (SHF) and diastolic heart failure (DHF) exhibit distinct left ventricular (LV) myocardial structural and functional differences. These cardiomyocyte abnormalities support the clinical separation of SHF and DHF phenotypes.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Heart Failure Pathophysiology

Background:

  • Distinguishing between systolic heart failure (SHF) and diastolic heart failure (DHF) is clinically important.
  • Left ventricular (LV) myocardial structure and function were investigated in patients with SHF and DHF.

Purpose of the Study:

  • To compare LV myocardial structure and function in patients with SHF versus DHF.
  • To identify distinct cardiomyocyte abnormalities contributing to different heart failure phenotypes.

Main Methods:

  • LV endomyocardial biopsy samples from SHF (n=22) and DHF (n=22) patients were analyzed.
  • Histomorphometry, electron microscopy, and isolated cardiomyocyte mechanical assessments were performed.
  • Passive and total force generation in cardiomyocytes were measured after stretching and calcium activation.

Main Results:

  • DHF patients had larger cardiomyocyte diameter but similar collagen fraction compared to SHF patients.
  • Myofibrillar density was lower in SHF cardiomyocytes.
  • DHF cardiomyocytes showed higher passive force but comparable total force, with a greater reduction after protein kinase A stimulation.

Conclusions:

  • Significant differences in LV myocardial structure and cardiomyocyte function exist between SHF and DHF.
  • These distinct abnormalities underpin the different phenotypes of systolic and diastolic heart failure.
  • Findings support the clinical separation of heart failure into SHF and DHF categories based on underlying myocardial characteristics.
Abstract

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