Faculty Collaboration Database

The relationship between myocardial extracellular matrix remodeling and ventricular function. Eur J Cardiothorac Surg 2006 Oct;30(4):604-10

Date

08/29/2006

Pubmed ID

16935520

DOI

10.1016/j.ejcts.2006.07.006

Scopus ID

2-s2.0-33748292887 (requires institutional sign-in at Scopus site)   228 Citations

Abstract

Elevations in myocardial stress initiate structural remodeling of the heart in an attempt to normalize the imposed stress. This remodeling consists of cardiomyocyte hypertrophy and changes in the amount of collagen, collagen phenotype and collagen cross-linking. Since fibrillar collagen is a relatively stiff material, a decrease in collagen can result in a more compliant ventricle while an increase in collagen or collagen cross-linking results in a stiffer ventricle. If continued elevations in wall stress exceed the ability of the heart to compensate, then the ventricular wall thickness is disproportionately reduced compared to chamber volume and diastolic and systolic dysfunction ensues. This review describes the structural organization of collagen within the myocardium, discusses its effect on ventricular function and considers whether therapy aimed at reducing fibrosis is efficacious in heart failure. The evidence indicates that chamber stiffness can clearly be affected by alterations in both collagen quantity and quality, with the effect of changes in collagen concentration being modified by the extent of collagen cross-linking. The limited evidence available regarding the effects of collagen on systolic function indicates that pharmacological attempts to reduce interstitial collagen have a negative impact. Accordingly, a shift in treatment strategies directed more specifically at affecting collagen cross-linking, rather than reducing the concentration of collagen, may be warranted in the prevention of the adverse impact of collagen alterations on myocardial remodeling.

Author List

Brower GL, Gardner JD, Forman MF, Murray DB, Voloshenyuk T, Levick SP, Janicki JS

MESH terms used to index this publication - Major topics in bold

Cardiomegaly
Extracellular Matrix
Fibrillar Collagens
Fibrosis
Humans
Myocardium
Ventricular Dysfunction
Ventricular Function
Ventricular Remodeling