title: Prognostic impact of myocardial interstitial fibrosis in non-ischemic heart failure. -Comparison between preserved and reduced ejection fraction heart failure.-.
abstract: BACKGROUND
  Although myocardial fibrosis plays an important role in the progression of heart failure (HF), its prognostic impact still remains to be clarified.
  
  
  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.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Aoki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
authors.forename: Koichiro
authors.initials: K
authors.lastname: Sugimura
authors.forename: Minako
authors.initials: M
authors.lastname: Oikawa
authors.forename: Kimio
authors.initials: K
authors.lastname: Satoh
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakano
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nakayama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001794:Blood Pressure; D004719:Endomyocardial Fibrosis / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume; D015996:Survival Rate