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Updated: Oct 1, 2025

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Microvascular Rarefaction and Myocardial Fibrosis in Hypertrophic Obstructive Cardiomyopathy: A Histopathological

Ming-Kui Zhang1, Zhengjie Zhang2, Hui Xue3

  • 1Heart Center, First Hospital of Tsinghua University, Beijing China. mingkuizhang@163.com.

The Heart Surgery Forum
|March 3, 2022
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) shows increased myocardial fibrosis in both children and adults. Microvascular density is reduced in adults with HOCM, suggesting microvascular changes contribute to fibrosis even in childhood.

Area of Science:

  • Cardiology
  • Pathology
  • Genetics

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is a genetic condition linked to microvascular ischemia and myocardial fibrosis.
  • The specific alterations in myocardial microvessels and fibrosis in pediatric versus adult HOCM patients are not well understood.
  • Microvessels are recognized as critical in the development of myocardial fibrosis within HOCM.

Purpose of the Study:

  • To investigate and compare changes in myocardial microvessel density (MVD) and myocardial fibrosis.
  • To analyze these changes in both pediatric and adult patients diagnosed with HOCM.

Main Methods:

  • Analysis of left ventricular septal wall specimens obtained via myectomy from 12 adult and 5 pediatric HOCM patients.
  • Comparison with control myocardial tissue from deceased individuals without cardiac conditions (5 adults, 4 pediatric).

Main Results:

  • Pediatric HOCM patients showed significantly increased myocardial fibrosis compared to controls, but MVD did not differ significantly.
  • Adult HOCM patients exhibited significantly reduced MVD and significantly increased myocardial fibrosis compared to controls.
  • No significant differences in MVD or myocardial fibrosis were observed between pediatric and adult HOCM groups.

Conclusions:

  • Both pediatric and adult HOCM patients present with elevated levels of myocardial fibrosis.
  • Findings suggest that myocardial microvascular density abnormalities may contribute to the development of myocardial fibrosis during childhood in HOCM.
  • Further research into early-stage microvascular changes in pediatric HOCM is warranted.
Abstract

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