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Prognostic value of the collagen volume fraction in hypertrophic cardiomyopathy

Edmundo Arteaga1, Aloir Queiroz de Araújo, Mauricio Bernstein

  • 1Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. edmundo.arteaga@incor.usp.br

Arquivos Brasileiros De Cardiologia
|April 25, 2009
PubMed

Insights

Interstitial myocardial fibrosis in hypertrophic cardiomyopathy (HCM) is linked to worse outcomes. Quantifying this fibrosis may help predict sudden death risk and guide treatment for HCM patients.

Area of Science:

  • Cardiology
  • Pathology
  • Medical Research

Background:

  • Interstitial myocardial fibrosis is a key feature in hypertrophic cardiomyopathy (HCM).
  • This fibrosis is associated with increased risk of sudden cardiac death and disease progression.
  • Accurate prognostic markers are crucial for managing HCM patients.

Purpose of the Study:

  • To prospectively assess the prognostic significance of collagen volume fraction (CVF) in patients with HCM.
  • To determine if CVF can predict adverse outcomes in HCM.
  • To establish a link between myocardial fibrosis and prognosis in HCM.

Main Methods:

  • Endomyocardial biopsies were obtained from 21 symptomatic HCM patients.
  • Myocardial collagen volume fraction (CVF) was quantified histologically.
  • Patients were stratified by median CVF, and outcomes were compared over a median follow-up of 110 months.

Main Results:

  • HCM patients exhibited significantly higher CVF (median 6.19%) compared to controls (median 0.61%).
  • No baseline clinical or echocardiographic differences were found between high and low CVF groups.
  • Increased CVF was associated with a significantly higher incidence of death (sudden cardiac death and heart failure) during follow-up (p=0.02).

Conclusions:

  • Myocardial fibrosis, quantified by CVF, is prospectively associated with a worse prognosis in HCM.
  • Quantifying myocardial fibrosis is essential for risk stratification in HCM.
  • This quantification may aid in decisions regarding defibrillator implantation and pharmacologic therapy for myocardial repair.
Abstract

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