Abstract 12377: Prognostic Impact of Myocardial Fibrosis in Patients with Heart Failure -Comparison between Preserved and Reduced Ejection Fraction Heart Failure
Background: Extracellular matrix plays an important role in the progression of heart failure (HF); however, its prognostic impact remains to be clarified.
Methods: We examined 210 consecutive patients with HF who underwent myocardial biopsy from January 2001 to May 2009 (male/female 145/65, mean age 56±13 [SD], ischemic or valvular heart disease excluded), and examined the prognostic impact of collagen volume fraction (CVF) in the biopsy samples. The primary endpoint was all-cause death. We divided them into 2 groups by left ventricular ejection fraction (LVEF); HF with preserved ejection fraction (HFPEF, LVEF>50%, n=97) and HF with reduced ejection fraction (HFREF, LVEF <50%, n=113).
Results: Mean follow-up period of HFPEF and HFREF was 37±32 and 37±27 months, respectively. Mean values of CVF were comparable between the 2 groups (1.67±1.50 vs. 1.89±2.20 %, n.s.). There was no significant difference in 5-year survival from all-cause death between the 2 groups (94% vs. 83%, n.s.). Subsequently, we divided both the HFPEF and HFREF groups into 2 groups using each median value (HFPEF and HFREF; 1.26% and 1.17%); the mild and sever fibrosis groups. In HFREF, but not in HFPEF, the severe fibrosis was a significant prognostic factor after adjustment of covariates using Cox regression model (Figures 1 and 2). Furthermore, CVF was significantly correlated with LVEDP in the HFREF group (P<0.01), but not in the HFPEF group.
Conclusions: These results indicate that myocardial fibrosis evaluated with biopsy samples is a useful predictor for long-term survival, suggesting that it may be an important therapeutic target as well.
- © 2011 by American Heart Association, Inc.