Myocardial fibrosis: Difference between revisions
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==Presentations== | ==Presentations== | ||
[[File:Gross pathology of old myocardial infarction.jpg|thumb|230px|Fibrosis, in this case an old myocardial infarction of the posterior wall of the left ventricle (seen as pale areas).]] | |||
[[File:Myocardium with patchy fibrosis.jpg|thumb|230px|Fibrosis consistent with old myocardial infarction, after formalin fixation.]] | |||
*[[Heart]], [[Heart autopsy|autopsy thereof]] and/or [[autopsy of myocardial infarction]]. | *[[Heart]], [[Heart autopsy|autopsy thereof]] and/or [[autopsy of myocardial infarction]]. | ||
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<gallery mode=packed heights=210> | <gallery mode=packed heights=210> | ||
File:Histopathology of interstitial fibrosis in dilated cardiomyopathy.jpg|Healthy myocardium versus '''interstitial fibrosis''' in dilated cardiomyopathy. Alcian blue stain. The fibrosis is either evenly distributed between myocytes or follows anatomic structures such as blood vessels. | File:Histopathology of interstitial fibrosis in dilated cardiomyopathy.jpg|Healthy myocardium versus '''interstitial fibrosis''' in dilated cardiomyopathy. Alcian blue stain. The fibrosis is either evenly distributed between myocytes or follows anatomic structures such as blood vessels. | ||
File:Histopathology of interstitial fibrosis of chronic ischemic heart disease.jpg|'''Interstitial fibrosis''' of chronic ischemic heart disease, H&E stain, with associated relatively well organized myocardial bundles | File:Histopathology of interstitial fibrosis of chronic ischemic heart disease.jpg|'''Interstitial fibrosis''' of chronic ischemic heart disease, H&E stain, with associated relatively well organized myocardial bundles, with rather rounded interfaces between myocyte bundles and fibrosis. | ||
File:Subepicardial fibrosis.jpg|'''Subepicardial fibrosis''' (epicardium at top). | File:Subepicardial fibrosis.jpg|'''Subepicardial fibrosis''' (epicardium at top). | ||
File:Histopathology of dense fibrous scar replacing myocyte loss in myocardial infarction.jpg|'''Replacement fibrosis''' in myocardial infarction, typically being boundless | File:Histopathology of dense fibrous scar replacing myocyte loss in myocardial infarction.jpg|'''Replacement fibrosis''' in myocardial infarction, typically displaying sharp interfaces between myocytes and fibrosis, and being more boundless and dense. | ||
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Latest revision as of 09:42, 1 December 2022
Author:
Mikael Häggström [note 1]
Presentations
Microscopic evaluation
In case of myocardial fibrosis, attempt to distinguish between the following:
- Interstitial fibrosis, which is unspecific,[1] (and may simply reported as such).[notes 1]
- Subepicardial fibrosis, also unspecific (and may simply be reported as such).[notes 2]
- Replacement fibrosis, which indicates an older infarction.[1]
-
Healthy myocardium versus interstitial fibrosis in dilated cardiomyopathy. Alcian blue stain. The fibrosis is either evenly distributed between myocytes or follows anatomic structures such as blood vessels. -
Interstitial fibrosis of chronic ischemic heart disease, H&E stain, with associated relatively well organized myocardial bundles, with rather rounded interfaces between myocyte bundles and fibrosis. -
Subepicardial fibrosis (epicardium at top). -
Replacement fibrosis in myocardial infarction, typically displaying sharp interfaces between myocytes and fibrosis, and being more boundless and dense.
Reporting
Example (if uncertain whether there is replacement fibrosis or merely subepicardial fibrosis):
 |
Notes
- ↑ Interstitial fibrosis has been described in congestive heart failure, hypertension, and normal aging. (Chute, 2019)
- ↑ Subepicardial fibrosis is associated with non-infarction diagnoses such as myocarditis and non-ischemic cardiomyopathy.
- Gräni, Christoph; Eichhorn, Christian; Bière, Loïc; Kaneko, Kyoichi; Murthy, Venkatesh L.; Agarwal, Vikram; Aghayev, Ayaz; Steigner, Michael; et al. (2019). "Comparison of myocardial fibrosis quantification methods by cardiovascular magnetic resonance imaging for risk stratification of patients with suspected myocarditis ". Journal of Cardiovascular Magnetic Resonance 21 (1). doi:. ISSN 1532-429X.
- Bhaskaran, Ashwin; Tung, Roderick; Stevenson, William G.; Kumar, Saurabh (2019). "Catheter Ablation of VT in Non-Ischaemic Cardiomyopathies: Endocardial, Epicardial and Intramural Approaches ". Heart, Lung and Circulation 28 (1): 84–101. doi:. ISSN 14439506.
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 Chute, Michael; Aujla, Preetinder; Jana, Sayantan; Kassiri, Zamaneh (2019). "The Non-Fibrillar Side of Fibrosis: Contribution of the Basement Membrane, Proteoglycans, and Glycoproteins to Myocardial Fibrosis ". Journal of Cardiovascular Development and Disease 6 (4): 35. doi:. ISSN 2308-3425.
Image sources