期刊
CIRCULATION JOURNAL
卷 75, 期 11, 页码 2605-2613出版社
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-11-0568
关键词
Collagen volume fraction; Ejection fraction; Fibrosis; Heart failure; Prognosis
资金
- Japanese Ministry of Education, Culture, Sports, Science and Technology, Tokyo, Japan [15256003, 16209027, 16659192, 19590803, 21590884]
- Japanese Ministry of Health, Labour, and Welfare, Tokyo, Japan [08005713, 09158526]
- Grants-in-Aid for Scientific Research [16209027, 21590884, 15256003, 16659192, 19590803] Funding Source: KAKEN
Background: Although myocardial fibrosis plays an important role in the progression of heart failure (HF), its prognostic impact still remains to be clarified. Methods and Results: A total of 172 consecutive patients with chronic HF, who underwent cardiac catheterization and endomyocardial biopsy between January 2001 and September 2008, were examined. They were divided into 2 groups: HF with preserved ejection fraction (HFPEF; left ventricular ejection fraction [LVEF] >= 50%, n=81); and HF with reduced LVEF (HFREF; LVEF <50%, n=91). The collagen volume fraction (CVF) in biopsy samples was calculated and its prognostic impact examined. Mean follow-up in the HFPEF and the HFREF groups was 41 +/- 33 months and 41 26 months, respectively. Although CVF was similar between the 2 groups (1.83 +/- 1.54% vs. 2.07 +/- 2.35%), CVF was significantly correlated with LV end-diastolic pressure in the HFREF group but not in the HFPEF group. When HF stage was adjusted, the long-term prognosis was comparable between the 2 groups. When the patients were divided into 2 groups according to median CVF, however, severe fibrosis was a significant predictor for all-cause death (P=0.014) and cardiac events (P=0.02) in the HFREF, but not in the HFPEF group. Conclusions: Myocardial fibrosis evaluated on biopsy samples is a useful indicator for long-term survival, suggesting that it may be an important therapeutic target as well. (Circ J 2011; 75: 2605-2613)
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