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Myocardial fibrosis and ventricular remodeling in severe chronic aortic regurgitation

Nelson Elias1, Flávio Tarasoutchi, Guilherme Sobreira Spina

  • 1Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Arquivos Brasileiros De Cardiologia
|February 17, 2009
PubMed

Insights

In patients with chronic severe aortic regurgitation, myocardial fibrosis was elevated but did not correlate with clinical outcomes or left ventricular remodeling. This suggests limited fibrosis may not impact complications in these patients.

Area of Science:

  • Cardiology
  • Cardiovascular Pathology
  • Cardiac Surgery

Background:

  • Symptomatic chronic aortic regurgitation (AR) causes significant left ventricular (LV) remodeling.
  • The role of interstitial fibrosis in AR pathophysiology is not well understood.

Purpose of the Study:

  • To evaluate the extent of myocardial fibrosis in patients with chronic severe aortic regurgitation.

Main Methods:

  • Twenty-eight symptomatic AR patients underwent echocardiography and cardiopulmonary testing.
  • Myocardial fibrosis volume fraction (MFV) was quantified via endomyocardial biopsy during surgery.
  • Histopathology was compared to a nine-patient control group.

Main Results:

  • Patients with AR showed significantly higher MFV compared to controls (3.47% vs 0.82%, p=0.001).
  • No correlation was found between LV fibrosis and LV dimensions, ejection fraction, or maximal oxygen consumption.
  • LV diameters significantly reduced post-surgery; functional capacity remained similar.

Conclusions:

  • Limited myocardial fibrosis in significant symptomatic AR is not associated with clinical, echocardiographic, or functional complications.
  • Further research may clarify the prognostic significance of varying fibrosis levels in AR.
Abstract

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