The Effect of Cardiac Fibrosis on Left Ventricular Remodeling, Diastolic Function, and N‐Terminal Pro‐B‐Type Natriuretic Peptide Levels in Patients with Nonischemic Dilated Cardiomyopathy

Abstract

Cardiac fibrosis correlates with impaired LV diastolic function and functional capacity, elevated NT-proBNP levels, and adverse cardiac remodeling in patients with NIDC. Therefore, the assessment of cardiac fibrosis can be useful in the management of these patients.

Assessment of Diffuse Myocardial Fibrosis in Rats Using Small-Animal Look-Locker Inversion Recovery T1 Mapping

“…3,4 Moreover, myocardial fibrosis plays an important role in the development of the second major factor contributing to morbidity and mortality of patients with chronic cardiovascular diseases and arrhythmia because it can cause significant alteration of the electric properties of the myocardium. 5,6 Therefore, accurate assessment of myocardial fibrosis is of important clinical interest.…”

Myocardial fibrosis detected by cardiac magnetic resonance imaging in heart failure: Impact on remodeling, diastolic function and BNP levels

“…Fibrosis that is detected by CMR is a frequent feature of left ventricular hypertrophy and it depends on the severity of LV remodeling (30). In a recent study by our group, left ventricle and atrium enlargement is observed when cardiac fibrosis is detected by LGE-CMR in the patients with dilated cardiomyopathy and a link between cardiac fibrosis and adverse LV remodeling is established (31,32).…”

“…Nelson et al (47) demonstrated that extent of dysfunctional myocardium (defined as a combination of viable and scarred myocardium) which is determined by CMR, has a moderately positive correlation with BNP levels. In another CMR study, a significant correlation was found between N-terminal-pro-BNP (NT-pro-BNP) levels and myocardial fibrosis and also NT-pro-BNP level was revealed as an independent predictor of cardiac fibrosis (31). Reciprocal interaction of myocardial fibrosis, LV remodeling and BNP secretion with each other has a complex role in heart failure.…”

“…It has been reported that a good correlation exists between diastolic functions and late gadolinium enhancement rate, suggesting that extend of LV fibrosis reflects LV diastolic function, which occurs earlier than systolic function (40). In another study, conventional and tissue Doppler echocardiography was used to assess the association of fibrosis and diastolic functions in dilated cardiomyopathy, although similar LV systolic functions were monitored, fibrosis was found to be linked with impaired diastolic function (31). These observations support the hypothesis that myocardial fibrosis causes aggravation of diastolic dysfunction.…”

“…The association of diastolic dysfunction and plasma BNP concentrations was studied in presence and absence of systolic dysfunction (45,31). In case of isolated diastolic dysfunction with preserved left ventricular systolic function, BNP levels were correlated to functional capacity determined by cardiopulmonary exercise test (45).…”