Abstract | BACKGROUND: METHODS AND RESULTS: We identified HFpEF patients (n=124) and age-appropriate control subjects (noncardiac death, no heart failure diagnosis; n=104) who underwent autopsy. Heart weight and CAD severity were obtained from the autopsy reports. With the use of whole-field digital microscopy and automated analysis algorithms in full-thickness left ventricular sections, microvascular density (MVD), myocardial fibrosis, and their relationship were quantified. Subjects with HFpEF had heavier hearts (median, 538 g; 169% of age-, sex-, and body size-expected heart weight versus 335 g; 112% in controls), more severe CAD (65% with ≥1 vessel with >50% diameter stenosis in HFpEF versus 13% in controls), more left ventricular fibrosis (median % area fibrosis, 9.6 versus 7.1) and lower MVD (median 961 versus 1316 vessels/mm(2)) than control (P<0.0001 for all). Myocardial fibrosis increased with decreasing MVD in controls (r=-0.28, P=0.004) and HFpEF (r=-0.26, P=0.004). Adjusting for MVD attenuated the group differences in fibrosis. Heart weight, fibrosis, and MVD were similar in HFpEF patients with CAD versus without CAD. CONCLUSIONS:
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Authors | Selma F Mohammed, Saad Hussain, Sultan A Mirzoyev, William D Edwards, Joseph J Maleszewski, Margaret M Redfield |
Journal | Circulation
(Circulation)
Vol. 131
Issue 6
Pg. 550-9
(Feb 10 2015)
ISSN: 1524-4539 [Electronic] United States |
PMID | 25552356
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Copyright | © 2014 American Heart Association, Inc. |
Topics |
- Aged
- Aged, 80 and over
- Algorithms
- Autopsy
- Cardiomegaly
(epidemiology, pathology)
- Cause of Death
- Comorbidity
- Coronary Artery Disease
(epidemiology, pathology)
- Coronary Vessels
(pathology)
- Diabetes Mellitus
(epidemiology)
- Echocardiography
- Electrocardiography
- Endomyocardial Fibrosis
(epidemiology, pathology, physiopathology)
- Female
- Heart
(anatomy & histology)
- Heart Failure
(diagnosis, epidemiology, pathology, physiopathology)
- Humans
- Immunohistochemistry
- Male
- Microvessels
(pathology)
- Myocardium
(pathology)
- Myocytes, Cardiac
(pathology)
- Organ Size
- Postmortem Changes
- Reference Values
- Stroke Volume
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