Document Detail

Regression of fibrosis and hypertrophy in failing myocardium following mechanical circulatory support.
MedLine Citation:
PMID:  11295584     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The cellular and structural changes that occur during long-term ventricular unloading leading to cardiac recovery are poorly understood. However, we have previously demonstrated that left ventricular assist device (LVAD) support leads to a significant decrease in intracardiac tumor necrosis factor-alpha (TNF-alpha), a protein capable of producing hypertrophy and fibrosis. METHODS: To further define the beneficial effects of long-term ventricular unloading on cardiac function, we determined the effect of mechanical circulatory support on fibrosis and hypertrophy in paired myocardial samples of 18 patients with end-stage cardiomyopathy obtained at the time of LVAD implantation and removal. RESULTS: We determined total collagen as well as collagen I and III by a semiquantitative analysis of positive immune-stained areas in pre- and post-LVAD myocardial samples. We found that total collagen content was reduced by 72% (p < 0.001), whereas collagen I content decreased by 66% (p < 0.001) and collagen III content was reduced by 62% (p < 0.001). Next, we determined myocyte size by direct analysis of cellular dimensions utilizing a computerized edge detection system in pre- and post-LVAD myocardial samples. We found that myocyte size decreased in all patients studied for an average reduction of 26% (33.1 +/- 1.32 to 24.4 +/- 1.64 microm, p < 0.001). CONCLUSION: These data demonstrate that long-term mechanical circulatory support significantly reduces collagen content and decreases myocyte size. We suggest that the reduction of fibrosis and hypertrophy observed may in part contribute to the recovery of cardiac function associated with long-term mechanical circulatory support.
B A Bruckner; S J Stetson; A Perez-Verdia; K A Youker; B Radovancevic; J H Connelly; M M Koerner; M E Entman; O H Frazier; G P Noon; G Torre-Amione
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  20     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-11     Completed Date:  2001-07-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-64     Citation Subset:  IM    
Department of Medicine and Surgery, Section of Cardiology, Gene and Judy Campbell Lab for Cardiac Transplant Research, Houston, Texas, USA.
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MeSH Terms
Analysis of Variance
Cardiomyopathy, Hypertrophic / metabolism,  physiopathology,  therapy*
Cell Size
Collagen / metabolism*
Heart-Assist Devices*
Middle Aged
Myocardium / cytology,  pathology*
Reg. No./Substance:

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