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Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis

Background: Hypertrophic cardiomyopathy (HCM) is characterized by myocardial disarray, small vessel disease (SVD), and fibrosis. The relationship between SVD and replacement-type fibrosis is still unclear. Methods: Histopathologic assessment of replacement-type fibrosis and SVD in HCM patients with...

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Autores principales: De Gaspari, Monica, Basso, Cristina, Perazzolo Marra, Martina, Elia, Stefania, Bueno Marinas, Maria, Angelini, Annalisa, Thiene, Gaetano, Rizzo, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913811/
https://www.ncbi.nlm.nih.gov/pubmed/33557065
http://dx.doi.org/10.3390/jcm10040575
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author De Gaspari, Monica
Basso, Cristina
Perazzolo Marra, Martina
Elia, Stefania
Bueno Marinas, Maria
Angelini, Annalisa
Thiene, Gaetano
Rizzo, Stefania
author_facet De Gaspari, Monica
Basso, Cristina
Perazzolo Marra, Martina
Elia, Stefania
Bueno Marinas, Maria
Angelini, Annalisa
Thiene, Gaetano
Rizzo, Stefania
author_sort De Gaspari, Monica
collection PubMed
description Background: Hypertrophic cardiomyopathy (HCM) is characterized by myocardial disarray, small vessel disease (SVD), and fibrosis. The relationship between SVD and replacement-type fibrosis is still unclear. Methods: Histopathologic assessment of replacement-type fibrosis and SVD in HCM patients with either end-stage heart failure (HF) or sudden cardiac death (SCD). Chronic ischemic heart disease (IHD) patients served as controls. Results: Forty HCM hearts, 10 HF and 30 SCD, were studied. Replacement-type fibrosis was detected in all HF and in 57% of SCD cases. In SCD, replacement-type fibrosis was associated with older age, greater septal thickness, SVD prevalence, and score (all p < 0.05). Prevalence of SVD did not show significant differences among SCD, HF, and IHD (73%, 100% and 95%, respectively), while SVD score was higher in HF than IHD and SCD (2.4, 1.95, and 1.18, respectively) and in areas with replacement-type fibrosis vs. those without in HF (3.4 vs. 1.4) and SCD (1.4 vs. 0.8) (all p < 0.05). Conclusions: SVD is a frequent feature in HCM independent of the clinical presentation. A higher SVD score is observed in HCM-HF and in areas with replacement-type fibrosis. Although SVD is part of the HCM phenotype, further remodeling of the microcirculation might occur secondarily to fibrosis.
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spelling pubmed-79138112021-02-28 Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis De Gaspari, Monica Basso, Cristina Perazzolo Marra, Martina Elia, Stefania Bueno Marinas, Maria Angelini, Annalisa Thiene, Gaetano Rizzo, Stefania J Clin Med Article Background: Hypertrophic cardiomyopathy (HCM) is characterized by myocardial disarray, small vessel disease (SVD), and fibrosis. The relationship between SVD and replacement-type fibrosis is still unclear. Methods: Histopathologic assessment of replacement-type fibrosis and SVD in HCM patients with either end-stage heart failure (HF) or sudden cardiac death (SCD). Chronic ischemic heart disease (IHD) patients served as controls. Results: Forty HCM hearts, 10 HF and 30 SCD, were studied. Replacement-type fibrosis was detected in all HF and in 57% of SCD cases. In SCD, replacement-type fibrosis was associated with older age, greater septal thickness, SVD prevalence, and score (all p < 0.05). Prevalence of SVD did not show significant differences among SCD, HF, and IHD (73%, 100% and 95%, respectively), while SVD score was higher in HF than IHD and SCD (2.4, 1.95, and 1.18, respectively) and in areas with replacement-type fibrosis vs. those without in HF (3.4 vs. 1.4) and SCD (1.4 vs. 0.8) (all p < 0.05). Conclusions: SVD is a frequent feature in HCM independent of the clinical presentation. A higher SVD score is observed in HCM-HF and in areas with replacement-type fibrosis. Although SVD is part of the HCM phenotype, further remodeling of the microcirculation might occur secondarily to fibrosis. MDPI 2021-02-04 /pmc/articles/PMC7913811/ /pubmed/33557065 http://dx.doi.org/10.3390/jcm10040575 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Gaspari, Monica
Basso, Cristina
Perazzolo Marra, Martina
Elia, Stefania
Bueno Marinas, Maria
Angelini, Annalisa
Thiene, Gaetano
Rizzo, Stefania
Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title_full Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title_fullStr Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title_full_unstemmed Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title_short Small Vessel Disease: Another Component of the Hypertrophic Cardiomyopathy Phenotype Not Necessarily Associated with Fibrosis
title_sort small vessel disease: another component of the hypertrophic cardiomyopathy phenotype not necessarily associated with fibrosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913811/
https://www.ncbi.nlm.nih.gov/pubmed/33557065
http://dx.doi.org/10.3390/jcm10040575
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