The role of storage of interstitial myocardial collagen on the overlife rate of patients with idiopathic and Chagasic dilated cardiomyopathy.
OBJECTIVE
To find out whether there is a correlation between a myocardial structural marker and the overlife rate of patients with dilated cardiomyopathy.


METHODS
Using endomyocardial biopsy and 2D-echocardiogram, we studied nine patients with no changes in myocardial structure (control) and 45 patients with severe dilated cardiomyopathy of idiopathic etiology (IDCM) and of Chagasic etiology (CDCM). We analyzed the correlation between the quantity of interstitial myocardial collagen (ICVF) and the overlife rates of these patients. We also evaluated the difference in ICVF between these groups and whether fibrosis interfered on the geometry and function of the myocardium.


RESULTS
We observed that ICVF was 15 times higher in cardiomyopathy patients than in the control group, but there was no difference in ICVF between CDCM and IDCM (*p < 0.001) patients. There was no correlation between ICVF and the overlife rate in cardiomyopathy patients (IDCM p = 0.249, and CDCM p = 0.587). We observed a significant correlation between ICVF and left ventricular ejection fraction (LVEF) only for IDCM. There was no correlation between ICVF and left ventricular diastolic diameter in either etiology.


CONCLUSIONS
There was no difference in myocardial fibrosis between patients with CDCM or IDCM, and there was no correlation between fibrosis and the prognosis either for IDCM or CDCM. There was a correlation between myocardial fibrosis and LVEF only for IDCM.
Nunes
Vera Lopes
VL
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil.
Ramires
Felix José Alvarez
FJ
Pimentel
Walace de Souza
Wde S
Fernandes
Fábio
F
Ianni
Barbara Maria
BM
Mady
Charles
C
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002311:Cardiomyopathy, Dilated / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D016022:Case-Control Studies; D002598:Chagas Cardiomyopathy / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D003094:Collagen / Q000032:analysis*; D004452:Echocardiography; D004719:Endomyocardial Fibrosis / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D012720:Severity of Illness Index; D016019:Survival Analysis
D015415:Biomarkers; D003094:Collagen