The implications for cardiac recovery of left ventricular assist device support on myocardial collagen content.
BACKGROUND
To define the beneficial cellular changes that occur with chronic ventricular unloading, we determined the effect of left ventricular assist device (LVAD) placement on myocardial fibrosis.


METHODS
We obtained paired myocardial samples (before and after LVAD implantation) from 10 patients (aged 43 to 64 years) with end-stage cardiomyopathy. We first determined regional collagen expression of an explanted heart by a computerized semiquantitative analysis of positive picro-sirius red stained areas.


RESULTS
We found that there was no statistically significant difference in collagen content between regions of the failed heart studied. Next we determined collagen content in these paired myocardial biopsies pre- and post-LVAD implantation. All 10 patients had significant reductions in collagen content after LVAD placement with a mean reduction of 82% (percent of tissue area stained decreased from 32% +/- 4% to 4% +/- 0.8%, P < 0.001).


CONCLUSIONS
In summary, these data demonstrate that chronic mechanical circulatory support significantly reduces fibrosis in the failing myocardium.
Bruckner
B A
BA
Department of Surgery, Baylor College of Medicine and DeBakey Heart Center, and the Texas Heart Institute, Houston, Texas, USA.
Stetson
S J
SJ
Farmer
J A
JA
Radovancevic
B
B
Frazier
O H
OH
Noon
G P
GP
Entman
M L
ML
Torre-Amione
G
G
Youker
K A
KA
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D003094:Collagen / Q000032:analysis*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D009206:Myocardium / Q000737:chemistry* / Q000473:pathology
D003094:Collagen