Myocardial fibrosis is defined as an increased amount of collagen in the myocardium relative to cardiac myocytes. Two main morphologic patterns are recognized: 1) replacement fibrosis, which occurs in response to myocyte necrosis (myocardial scarring); and 2) interstitial fibrosis, which is usually a diffuse process and has been shown to be reversible and treatable. Replacement and interstitial fibrosis often coexist and are a constant feature of pathologic cardiac remodeling. In the last twenty years, there has been significant interest in developing objective non-invasive methods to identify and quantitatively assess myocardial fibrosis in vivo, both for diagnostic purposes and to improve stratification of patients. The present Review focuses on the morphologic patterns of myocardial fibrosis observed either at autopsy and heart transplant, or in vivo by non-invasive imaging techniques. Main aim is to provide clues for the differential diagnosis, with emphasis on entities whose diagnosis may be challenging. An update on the diagnostic and prognostic role of imaging, along with recent data on available biomarkers are also proposed.
Myocardial fibrosis: morphologic patterns and role of imaging in diagnosis and prognostication / Giordano, Carla; Francone, Marco; Cundari, Giulia; Pisano, Annalinda; D'Amati, Giulia. - In: CARDIOVASCULAR PATHOLOGY. - ISSN 1054-8807. - 56:(2021). [10.1016/j.carpath.2021.107391]
Myocardial fibrosis: morphologic patterns and role of imaging in diagnosis and prognostication
Giordano, Carla
Primo
Conceptualization
;Francone, MarcoSecondo
Membro del Collaboration Group
;Cundari, GiuliaMembro del Collaboration Group
;Pisano, AnnalindaPenultimo
Membro del Collaboration Group
;d'Amati, GiuliaUltimo
Writing – Review & Editing
2021
Abstract
Myocardial fibrosis is defined as an increased amount of collagen in the myocardium relative to cardiac myocytes. Two main morphologic patterns are recognized: 1) replacement fibrosis, which occurs in response to myocyte necrosis (myocardial scarring); and 2) interstitial fibrosis, which is usually a diffuse process and has been shown to be reversible and treatable. Replacement and interstitial fibrosis often coexist and are a constant feature of pathologic cardiac remodeling. In the last twenty years, there has been significant interest in developing objective non-invasive methods to identify and quantitatively assess myocardial fibrosis in vivo, both for diagnostic purposes and to improve stratification of patients. The present Review focuses on the morphologic patterns of myocardial fibrosis observed either at autopsy and heart transplant, or in vivo by non-invasive imaging techniques. Main aim is to provide clues for the differential diagnosis, with emphasis on entities whose diagnosis may be challenging. An update on the diagnostic and prognostic role of imaging, along with recent data on available biomarkers are also proposed.File | Dimensione | Formato | |
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Giordano_Myocardial fibrosis_2021.pdf
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