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Related Experiment Videos

Functional and structural abnormalities in patients with dilated cardiomyopathy.

A S Bortone1, O M Hess, A Chiddo

  • 1Division of Cardiology, University of Bari, Italy.

Journal of the American College of Cardiology
|September 1, 1989
PubMed
Summary

Dilated cardiomyopathy can present with normal myocardial stiffness despite impaired systolic function. Increased interstitial fibrosis correlates with elevated myocardial stiffness, indicating advanced disease.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Pathology

Background:

  • Dilated cardiomyopathy (DCM) is characterized by impaired left ventricular systolic function.
  • Passive diastolic properties, crucial for cardiac function, are often altered in DCM.
  • Understanding myocardial stiffness in DCM is vital for disease staging and management.

Purpose of the Study:

  • To assess passive diastolic properties of the left ventricle in patients with DCM.
  • To investigate the relationship between myocardial stiffness and structural abnormalities in DCM.
  • To determine if myocardial stiffness can differentiate disease severity in DCM.

Main Methods:

  • Simultaneous left ventricular angiography and pressure measurements were performed.
  • Left ventricular pressure-volume and stress-strain relations were used to calculate chamber and myocardial stiffness constants.

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  • Morphometry of right ventricular endomyocardial biopsies assessed interstitial fibrosis and fibrous content.

    • Main Results:

    • Patients with DCM had significantly higher left ventricular end-diastolic pressure and lower ejection fraction than controls.
    • Myocardial stiffness (beta) was normal in one DCM group but significantly increased in another, correlating with higher interstitial fibrosis (up to 43%).
    • An exponential relationship was found between myocardial stiffness and interstitial fibrosis.

    Conclusions:

    • Myocardial stiffness can be normal in DCM patients with severely depressed systolic function.
    • Increased myocardial stiffness in DCM is likely due to structural alterations, specifically increased fibrous tissue.
    • The myocardial stiffness constant (beta) can identify patients with severe structural changes, potentially indicating advanced DCM.