دورية أكاديمية

Role of Myocardial Collagen in Severe Aortic Stenosis With Preserved Ejection Fraction and Symptoms of Heart Failure.

التفاصيل البيبلوغرافية
العنوان: Role of Myocardial Collagen in Severe Aortic Stenosis With Preserved Ejection Fraction and Symptoms of Heart Failure.
المؤلفون: Echegaray, Kattalin, Andreu, Ion, Lazkano, Ane, Villanueva, Iñaki, Sáenz, Alberto, Elizalde, María Reyes, Echeverría, Tomás, López, Begoña, Garro, Asier, González, Arantxa, Zubillaga, Elena, Solla, Itziar, Sanz, Iñaki, González, Jesús, Elósegui-Artola, Alberto, Roca-Cusachs, Pere, Díez, Javier, Ravassa, Susana, Querejeta, Ramón
المصدر: Revista Española de Cardiología (18855857); Oct2017, Vol. 70 Issue 10, p832-840, 9p
الملخص (بالإنجليزية): Introduction and objectives We investigated the anatomical localization, biomechanical properties, and molecular phenotype of myocardial collagen tissue in 40 patients with severe aortic stenosis with preserved ejection fraction and symptoms of heart failure. Methods Two transmural biopsies were taken from the left ventricular free wall. Mysial and nonmysial regions of the collagen network were analyzed. Myocardial collagen volume fraction (CVF) was measured by picrosirius red staining. Young's elastic modulus (YEM) was measured by atomic force microscopy in decellularized slices to assess stiffness. Collagen types I and III were measured as C I VF and C III VF, respectively, by confocal microscopy in areas with YEM evaluation. Results Compared with controls, patients exhibited increased mysial and nonmysial CVF and nonmysial:mysial CVF ratio ( P < .05). In patients, nonmysial CVF (r = 0.330; P = .046) and the nonmysial:mysial CVF ratio (r = 0.419; P = .012) were directly correlated with the ratio of maximal early transmitral flow velocity in diastole to early mitral annulus velocity in diastole. Both the C I VF:C III VF ratio and YEM were increased ( P ≤ .001) in nonmysial regions compared with mysial regions in patients, with a direct correlation ( r = 0.895; P < .001) between them. Conclusions These findings suggest that, in patients with severe aortic stenosis with preserved ejection fraction and symptoms of heart failure, diastolic dysfunction is associated with increased nonmysial deposition of collagen, predominantly type I, resulting in increased extracellular matrix stiffness. Therefore, the characteristics of collagen tissue may contribute to diastolic dysfunction in these patients. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Resumen Introducción y objetivos Se ha estudiado la localización anatómica, las propiedades biomecánicas y el fenotipo molecular del colágeno miocárdico tisular en 40 pacientes con estenosis aórtica grave, fracción de eyección conservada y síntomas de insuficiencia cardiaca. Métodos Se obtuvieron 2 biopsias transmurales de la pared libre del ventrículo izquierdo. La fracción del volumen de colágeno (FVC) se cuantificó mediante rojo picrosirio y la rigidez, mediante el módulo elástico de Young (YEM) evaluado con microscopia de fuerza atómica en regiones misiales y no misiales. Las FVC de tipos I y III se cuantificaron mediante microscopia confocal en áreas con determinación del YEM. Resultados Comparados con sujetos de control, la FVC misial y no misial y el cociente FVC no misial:misial (p < 0,05) estaban incrementados en los pacientes. El cociente entre la velocidad pico de la onda E mitral y la velocidad E del anillo lateral mitral de los pacientes se correlacionaba con la FVC no misial (r = 0,330; p = 0,046) y con el cociente FVC no misial:misial (r = 0,419; p = 0,012). El cociente FVC I :FVC III y el YEM aumentaban (p ≤ 0,001) en regiones no misiales respecto de las misiales, con correlación entre ellos (r = 0,895; p < 0,001). Conclusiones En la estenosis aórtica grave con fracción de eyección conservada y síntomas de insuficiencia cardiaca, la disfunción diastólica se asocia con un depósito no misial de colágeno aumentado, predominantemente de tipo I y con mayor rigidez. Las características del colágeno tisular pueden contribuir a la disfunción diastólica en estos pacientes. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Supplemental Index
الوصف
تدمد:18855857
DOI:10.1016/j.rec.2016.12.038