Comments on: Influence of Myocardial Fibrosis on Left Ventricular Diastolic Function http://www.thepreparedminds.com/archives/582 In the field of observation, chance favors the prepared minds. Sat, 04 Feb 2012 14:45:45 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Jacobo Kirsch, MD http://www.thepreparedminds.com/archives/582/comment-page-1#comment-477 Jacobo Kirsch, MD Tue, 24 Nov 2009 02:10:03 +0000 http://www.thepreparedminds.com/?p=582#comment-477 Every few months more <a href="http://www.thepreparedminds.com/archives/237" rel="nofollow">evidence</a> keeps accumulating regarding the contribution of myocardial fibrosis to the pathogenesis of diastolic dysfunction, and specifically the use of MRI to assess these underlying myocardial changes. There are many interesting findings in this study, among them: - The authors found NO LV segments with persistent late enhancement in those subject without structural heart disease (42 out of 204,20%). This is not in keeping with other prior studies were some mid-myocardial enhancement has been reported. - There were 63 (31%) of subjects with normal diastolic parameters as established by the methods. The majority of these subjects (87%) had no foci of late enhancement. - When the patients were divided by EF, by either less or more than 50%, the statistical analysis still showed significance in the relationship between late enhancement and diastolic function. - One of the most interesting findings is that there was no correlation between the E/E' and the pathologic etiology. Furthermore, in addition to the severity of fibrosis, only its location in the septum was significantly and independently associated with E/E', again regardless of the etiology. Every few months more evidence keeps accumulating regarding the contribution of myocardial fibrosis to the pathogenesis of diastolic dysfunction, and specifically the use of MRI to assess these underlying myocardial changes.

There are many interesting findings in this study, among them:

- The authors found NO LV segments with persistent late enhancement in those subject without structural heart disease (42 out of 204,20%). This is not in keeping with other prior studies were some mid-myocardial enhancement has been reported.

- There were 63 (31%) of subjects with normal diastolic parameters as established by the methods. The majority of these subjects (87%) had no foci of late enhancement.

- When the patients were divided by EF, by either less or more than 50%, the statistical analysis still showed significance in the relationship between late enhancement and diastolic function.

- One of the most interesting findings is that there was no correlation between the E/E’ and the pathologic etiology. Furthermore, in addition to the severity of fibrosis, only its location in the septum was significantly and independently associated with E/E’, again regardless of the etiology.

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