心肌纤维化与左束支阻滞的关系。它存在吗？

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology Pub Date : 2024-12-31 DOI:10.1016/j.carpath.2024.107713

Elena Rimskaya , Olga Aparina , Olga Stukalova , Semen Kormilitsyn , Nataliia Mironova , Petr Chumachenko , Sergey Ternovoy , Sergey Golitsyn

{"title":"心肌纤维化与左束支阻滞的关系。它存在吗？","authors":"Elena Rimskaya , Olga Aparina , Olga Stukalova , Semen Kormilitsyn , Nataliia Mironova , Petr Chumachenko , Sergey Ternovoy , Sergey Golitsyn","doi":"10.1016/j.carpath.2024.107713","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>to assess the relation of focal and diffuse left ventricular (LV) fibrosis to left bundle branch block (LBBB).</div></div><div><h3>Materials and methods</h3><div>60 patients with dilated cardiomyopathy and LBBB (DCM-LBBB), 50 DCM-nonLBBB patients, 15 patients with LBBB and structurally normal heart (idiopathic LBBB) and 10 healthy volunteers (HV) underwent cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). LGE LV images were post-proceeded for core scar (CS) and gray zone (GZ) calculation. Diffuse LV fibrosis was estimated on LGE-CMR images with the diffuse intensity ratio (DIR). Endomyocardial biopsy (EMB) was performed in 15(24.6 %) DCM-LBBB and 16 (32 %) non-LBBB DCM patients and allowed the quantification of collagen volume fraction (CVF).</div></div><div><h3>Results</h3><div>The percentage of CVF correlated with the DIR value in the same segment (<em>r</em> = 0.66, <em>p</em> < 0.001). The value of CVF in EMB and frequency of LGE in both DCM groups was comparable (<em>p</em> = 0.8). In DCM-nonLBBB patients the percentage of CS was significantly higher (4.0[1.6; 11.7]% versus 1.4[0.1;8.5]% in DCM-LBBB patients, <em>p</em> = 0.047), whereas percentage of GZ and total fibrosis in both DCM groups was comparable. DIR value was higher in patients with idiopathic LBBB than in HV (0.54±0.09 versus 0.34±0.1, р<0,001).</div></div><div><h3>Conclusion</h3><div>Neither focal nor interstitial fibrosis is associated with LBBB in DCM patients. Diffuse inflammation in DCM-LBBB patients may contribute to the progression of systolic dysfunction but is not a cause of LBBB. The increased value of interstitial fibrosis in patients with idiopathic LBBB may reflect latent diffuse process in myocardium inexorably leading to DCM development.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"75 ","pages":"Article 107713"},"PeriodicalIF":2.3000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Relationship between myocardial fibrosis and left bundle branch block. Does it exist?\",\"authors\":\"Elena Rimskaya , Olga Aparina , Olga Stukalova , Semen Kormilitsyn , Nataliia Mironova , Petr Chumachenko , Sergey Ternovoy , Sergey Golitsyn\",\"doi\":\"10.1016/j.carpath.2024.107713\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><div>to assess the relation of focal and diffuse left ventricular (LV) fibrosis to left bundle branch block (LBBB).</div></div><div><h3>Materials and methods</h3><div>60 patients with dilated cardiomyopathy and LBBB (DCM-LBBB), 50 DCM-nonLBBB patients, 15 patients with LBBB and structurally normal heart (idiopathic LBBB) and 10 healthy volunteers (HV) underwent cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). LGE LV images were post-proceeded for core scar (CS) and gray zone (GZ) calculation. Diffuse LV fibrosis was estimated on LGE-CMR images with the diffuse intensity ratio (DIR). Endomyocardial biopsy (EMB) was performed in 15(24.6 %) DCM-LBBB and 16 (32 %) non-LBBB DCM patients and allowed the quantification of collagen volume fraction (CVF).</div></div><div><h3>Results</h3><div>The percentage of CVF correlated with the DIR value in the same segment (<em>r</em> = 0.66, <em>p</em> < 0.001). The value of CVF in EMB and frequency of LGE in both DCM groups was comparable (<em>p</em> = 0.8). In DCM-nonLBBB patients the percentage of CS was significantly higher (4.0[1.6; 11.7]% versus 1.4[0.1;8.5]% in DCM-LBBB patients, <em>p</em> = 0.047), whereas percentage of GZ and total fibrosis in both DCM groups was comparable. DIR value was higher in patients with idiopathic LBBB than in HV (0.54±0.09 versus 0.34±0.1, р<0,001).</div></div><div><h3>Conclusion</h3><div>Neither focal nor interstitial fibrosis is associated with LBBB in DCM patients. Diffuse inflammation in DCM-LBBB patients may contribute to the progression of systolic dysfunction but is not a cause of LBBB. The increased value of interstitial fibrosis in patients with idiopathic LBBB may reflect latent diffuse process in myocardium inexorably leading to DCM development.</div></div>\",\"PeriodicalId\":9451,\"journal\":{\"name\":\"Cardiovascular Pathology\",\"volume\":\"75 \",\"pages\":\"Article 107713\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1054880724001091\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Pathology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1054880724001091","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

目的：探讨局灶性和弥漫性左室纤维化与左束支传导阻滞的关系。材料与方法：60例扩张型心肌病合并LBBB （DCM-LBBB）、50例dcm -非LBBB、15例LBBB合并结构正常（特发性LBBB）和10例健康志愿者（HV）行心血管磁共振（CMR）晚期钆增强（LGE）。LGE LV图像为核心疤痕（CS）和灰色区域（GZ）计算的后处理。弥漫性左室纤维化在LGE-CMR图像上用弥漫性强度比（DIR）估计。15例（24.6%）DCM- lbbb患者和16例（32%）非lbbb DCM患者进行了心内膜心肌活检（EMB），并允许胶原体积分数（CVF）的量化。结果：CVF百分比与同一节段的DIR值相关（r=0.66, p）。结论：局灶性（包括中壁条纹）和间质性纤维化与DCM患者的LBBB无关。DCM-LBBB患者的弥漫性炎症可能有助于收缩功能障碍的进展，但不是LBBB的原因。LBBB患者间质纤维化值升高可能反映了心肌的潜伏弥漫性过程不可避免地导致DCM的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Relationship between myocardial fibrosis and left bundle branch block. Does it exist?

查看原文本刊更多论文

Relationship between myocardial fibrosis and left bundle branch block. Does it exist?

Aim

to assess the relation of focal and diffuse left ventricular (LV) fibrosis to left bundle branch block (LBBB).

Materials and methods

60 patients with dilated cardiomyopathy and LBBB (DCM-LBBB), 50 DCM-nonLBBB patients, 15 patients with LBBB and structurally normal heart (idiopathic LBBB) and 10 healthy volunteers (HV) underwent cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). LGE LV images were post-proceeded for core scar (CS) and gray zone (GZ) calculation. Diffuse LV fibrosis was estimated on LGE-CMR images with the diffuse intensity ratio (DIR). Endomyocardial biopsy (EMB) was performed in 15(24.6 %) DCM-LBBB and 16 (32 %) non-LBBB DCM patients and allowed the quantification of collagen volume fraction (CVF).

Results

The percentage of CVF correlated with the DIR value in the same segment (r = 0.66, p < 0.001). The value of CVF in EMB and frequency of LGE in both DCM groups was comparable (p = 0.8). In DCM-nonLBBB patients the percentage of CS was significantly higher (4.0[1.6; 11.7]% versus 1.4[0.1;8.5]% in DCM-LBBB patients, p = 0.047), whereas percentage of GZ and total fibrosis in both DCM groups was comparable. DIR value was higher in patients with idiopathic LBBB than in HV (0.54±0.09 versus 0.34±0.1, р<0,001).

Conclusion

Neither focal nor interstitial fibrosis is associated with LBBB in DCM patients. Diffuse inflammation in DCM-LBBB patients may contribute to the progression of systolic dysfunction but is not a cause of LBBB. The increased value of interstitial fibrosis in patients with idiopathic LBBB may reflect latent diffuse process in myocardium inexorably leading to DCM development.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Cardiovascular Pathology 医学-病理学

CiteScore

7.50

自引率

2.70%

发文量

审稿时长

18 days

期刊介绍： Cardiovascular Pathology is a bimonthly journal that presents articles on topics covering the entire spectrum of cardiovascular disease. The Journal''s primary objective is to publish papers on disease-oriented morphology and pathogenesis from clinicians and scientists in the cardiovascular field. Subjects covered include cardiovascular biology, prosthetic devices, molecular biology and experimental models of cardiovascular disease.