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Dissociation Between Interstitial Fibrosis and Conventional Right Ventricular Assessment Markers in Advanced Heart
Michael J Bonios1, Dimitris Miliopoulos1, Eleni Tseliou2
1From the Departments of Cardiology and Cardiac Surgery, Heart Failure and Transplant Units, Onassis Cardiac Surgery Center, Athens, Greece.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|March 25, 2026
Summary
Right ventricular interstitial fibrosis in heart failure patients is independent of traditional functional markers. This finding suggests fibrosis may offer a stable indicator for assessing right ventricular reserve and prognosis before left ventricular assist device implantation.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pathology
Background:
- Assessing right ventricular (RV) failure risk in heart failure (HF) patients before left ventricular assist device (LVAD) implantation is complex.
- Conventional hemodynamic, echocardiographic, and biochemical RV parameters are dynamic and can fluctuate.
- Interstitial fibrosis in the RV may represent a more stable, intrinsic marker of RV health.
Purpose of the Study:
- To investigate whether RV interstitial fibrosis is independent of conventional RV functional parameters in patients undergoing LVAD implantation.
- To explore the potential of RV interstitial fibrosis as a less dynamic marker for RV assessment.
Main Methods:
- Nineteen patients with INTERMACS profiles I-III undergoing LVAD implantation were studied.
- Preoperative echocardiographic and hemodynamic data were collected.
- Myocardial tissue samples from the RV free wall were analyzed for interstitial fibrosis quantification.
Main Results:
- RV interstitial fibrosis did not correlate with preoperative hemodynamic, echocardiographic, or biochemical markers of RV function.
- Left ventricular and RV interstitial fibrosis showed a moderate correlation (r = 0.48, p = 0.04).
- All patients required inotropic support, and 17 used intra-aortic balloon pump support.
Conclusions:
- In advanced heart failure patients, RV interstitial fibrosis is independent of conventional RV functional parameters.
- RV interstitial fibrosis may serve as a complementary, less dynamic marker for evaluating intrinsic RV functional reserve and prognosis.
- Further research is needed to validate the role of RV interstitial fibrosis in predicting outcomes.
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