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 patient...

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Bibliographic Details
Published in:The American journal of surgery 2000-12, Vol.180 (6), p.498-502
Main Authors: Bruckner, Brian A, Stetson, Sonny J, Farmer, John A, Radovancevic, Branislav, Frazier, O.H, Noon, George P, Entman, Mark L, Torre-Amione, Guillermo, Youker, Keith A
Format: Article
Language:English
Subjects:
Adult
Biopsy
Blood & organ donations
Cardiac function
Cardiomyopathy
Cardiomyopathy, Dilated - surgery
Collagen
Collagen - analysis
Female
Fibrosis
Heart
Heart failure
Heart-Assist Devices
Humans
Implantation
Ischemia
Male
Mechanical unloading
Middle Aged
Myocardial Ischemia - surgery
Myocardium
Myocardium - chemistry
Myocardium - pathology
Patients
Regions
Stains & staining
Statistical analysis
Ventricle
Ventricular assist devices
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Summary: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). Conclusion: In summary, these data demonstrate that chronic mechanical circulatory support significantly reduces fibrosis in the failing myocardium.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(00)00553-5