Usefulness of the electrocardiogram and echocardiogram in predicting the amount of interstitial myocardial collagen in endomyocardial biopsy specimens of patients with chronic heart failure.

Myocardial fibrosis constitutes a nonspecific common pathway of myocardial response to injury. There is increasing evidence for the unfavorable effect of myocardial fibrosis on the outcome of patients with myocardial disease.1 Adverse functional effects of myocardial collagen have been shown in systemic hypertension,2 aortic valve stenosis,3 idiopathic dilated cardiomyopathy4 and other myocardial diseases.5 However, initial and serial assessment of the severity of myocardial fibrosis is difficult in the absence of a practical and noninvasive method. Endomyocardial biopsy allows direct visualization and quantitation of the structural components of the myocardium. Using data obtained from endomyocardial biopsies in 24 patients, we sought to develop a noninvasive method of estimation of the degree of myocardial fibrosis.