Histopathologic findings in explanted heart tissue from patients with end-stage idiopathic dilated cardiomyopathy

Abstract

Explanted hearts were examined to determine whether specific histopathologic features are present in the myocardium of patients with end‐stage idiopathic dilated cardiomyopathy (IDC). Extensive histopathologic examination by light microscopy, electron microscopy and immunohistochemistry revealed marked fibrosis in the hearts of 21 of 37 IDC patients and in 26 of 35 patients with heart diseases of known causes. Reactive (interstitial and perivascular) fibrosis predominated in the IDC hearts, whereas both reparative (replacement) fibrosis and reactive fibrosis were found in the comparison group. Endocardial fibroelastosis was found in nine patients with IDC and in 14 patients from the comparison group. Distinct patterns of fibrosis were the sole significant histopathologic difference between myocardial samples from patients with IDC and from those with heart diseases of known causes. The diffuse presence of reactive fibrosis in IDC patients suggests a more generalised dysfunction that affects the composition of the myocardial extracellular matrix.

Assessment of myocardial fibrosis by endoventricular electromechanical mapping in experimental nonischemic cardiomyopathy

“…The presence of fibrosis as determined by DE-CMR has been reported to predict functional recovery over time [23] and adverse outcome, including progression of heart failure and sudden cardiac death [3]. In the current study, doxorubicin-treated sheep had increased LV fibrosis, as corroborated by histology and DE-CMR, and both the burden and heterogeneous distribution of fibrosis were consistent with descriptions from CMR [3,24], necropsy [25], surgical [11,26,27] and biopsy [22] studies of patients with NICM. These important characteristics provided the basis for us to use our model to evaluate the potential of electromechanical mapping to identify myocardial regions with increased fibrosis, that ultimately could be targeted for diagnostic or therapeutic interventions in NICM.…”

Gadolinium-enhanced magnetic resonance imaging for detection and quantification of fibrosis in human myocardium in vitro

“…We have reported abnormally high Gd partition coefficients for patients with idiopathic dilated cardiomyopathy (IDC), compared to asymptomatic relatives [8]. IDC patients have been shown to be burdened by abnormally high levels of myocardial interstitial fibrosis [9][10][11]. These preliminary findings already provide evidence of the feasibility of using in-vivo MRI to detect fibrosis in the absence of focal hyper-enhancement.…”

Association of miR-197-5p, a Circulating Biomarker for Heart Failure, with Myocardial Fibrosis and Adverse Cardiovascular Events among Patients with Stage C or D Heart Failure

“…The result suggested that miR-197-5p could be used as a biomarker for remodeling processes in end-stage HF. Histologically, the main feature of end-stage damaged myocardium in patients with stage C or D HF is the development of interstitial and replacement fibrosis that varies in severity [19]. We recently reported that the percentage of myocardial fibrosis seen in the CMRI in patients with end-stage HF was significantly high (76.6%) [4].…”