The immobilizing interstitial fibrosis of the heart. Part 2

The fibrosis is an important pathophysiological basis of heart failure. It is determined in cardiomyopathies of various genesis. According to the results of numerous experimental and clinical studies, the possibility of an isolated violation of the structure of the endomysium and perimysium, with a tendency to compaction and gradual mechanical compression of cardiomyocytes - immobilization, has been revealed. Moreover, this process gradually reaches such a degree of coarsening that the formed framework around individual cardiomyocytes and their bundles prevents first a full-fledged diastole, and later systole. This particular form is called "the immobilizing interstitial fibrosis of the heart”. Conclusion. The immobilizing interstitial fibrosis of the heart is one of the main independent causes of heart failure not associated with atherosclerotic lesions of the coronary arteries. In advanced stages, such fibrosis can lead to coronary artery disease as a result of extravascular compression of arterioles. An isolated violation of the structure of the endomysium and perimysium, manifested by excessive collagen production of types I and III, increases myocardial stiffness and changes cardiodynamics. Antifibrosis strategies aimed at preventing unfavorable remodeling of the heart are becoming a promising approach in the prevention and treatment of heart failure and require further in-depth clinical studies.