Everything You Need to Know About Myocardial Fibrosis

The disorder known as myocardial fibrosis results in the accumulation of scar tissue in your heart. Although it can happen at other times as well, it usually happens after a heart attack.

The scarring of your heart muscle is known as myocardial fibrosis, also known as fibrosis of the myocardium. Myocardial fibrosis can be caused by any disorder that harms your heart, but heart attacks are the most common culprit.

The Centers for Disease Control and Prevention (CDC)Trusted Source estimates that about 805,000 Americans get a heart attack each year.

The primary focus of myocardial fibrosis treatment is addressing the underlying causes. For instance, those who experience heart failure brought on by diabetes-related myocardial fibrosisDiabetes and heart failure are addressed in Trusted Source.

In this article, we examine cardiac fibrosis in further detail, including its kinds, causes, and available treatments.

Myocardial fibrosis: what is it?
Scarring of the heart muscles results from an acute or ongoing heart injury and is known as myocardial fibrosis. The term “myocardial” refers to the heart muscle, while the term “fibrosis” is the medical term for scarring.

Your body will quickly heal an injury by producing scar tissue, but this new tissue lacks the contractile capabilities of healthy cardiac tissue.

Heart failure may result from myocardial fibrosis.Reliable Source. When your heart cannot pump enough blood to meet your body’s needs, heart failure sets in.

An increased risk of cardiac failure is associated with more scarring.

The myocardium is what?
The three layers of tissue that make up your heart are known as the:

epicardium myocardium endocardium
The middle layer of your heart is called the myocardium. This layer comprises the majority.a Reliable Source of your heart’s muscle, which enables your heart to beat and pump blood.

Myocardial fibrosis types
Myocardial fibrosis is typically divided into two categories by doctors.Replacement and interstitial are reliable sources. Replacement fibrosis occurs when scar tissue develops as a result of muscle cell death. Scar tissue develops in the area between muscle cells, causing interstitial fibrosis, which is unrelated to the death of muscle cells.

Reactive and infiltrative interstitial fibrosis are two more subtypes that can be distinguished. Reactive interstitial fibrosis, which manifests in aging disorders like diabetes or high blood pressure, is characterized by the formation of scar tissue in reaction to pressure or blood volume excess.

When the heart deposits proteins and a class of chemicals known as “glycosphingolipids,” infiltrative fibrosis results. Amyloidosis and Anderson-Fabry illness both exhibit this type of fibrosis.

Interstitial fibrosis and replacement can both occur simultaneously.

Myocardial fibrosis symptoms
Underlying cardiac disease is the cause of myocardial fibrosis. Heart failure can result from the loss of heart function brought on by scarring.

Heart failure symptoms can include:

breathing difficulty
feeble and weary
swelling in the lower body an unpredictable or fast heartbeat
breathing difficulties while laying down (orthopnea)
Paroxysmal nocturnal dyspnea is a continuous cough that may produce white or pink mucus and causes edema around the abdomen.
focus issues and a decline in alertness
nauseous and undernourished
quick rise in weight

How is cardiac fibrosis brought on?
Your heart can sustain acute or ongoing injury that leads to myocardial fibrosis. Damage could be caused by:

cardiac arrests
volume overload, toxicity, and pressure overload
genetic changes
Heart attack, or myocardial infarction
Heart attacks, or myocardial infarction, are the main cause of myocardial fibrosis. A heart attack happens when an area of your heart doesn’t get enough blood flow because of an artery blockage.

Heart cells die as a result of poor blood flow. When dead muscle cells are replaced, fibrosis occurs.

pressure buildup
Reactive myocardial fibrosis can be brought on by conditions that put your heart under constant strain. Your heart develops scar tissue as a defense against the increased pressure.

Possible reasonsSome reliable sources are:

blood pressure is high.
heart valve stenosis
hypertension in the pulmonary arteries
stenosis of the pulmonary valve
Volume excess
Aortic or mitral regurgitation are two disorders that can result in an excess of blood volume and induce myocardial fibrosis. When blood flows backward via the heart, these situations arise. A blood volume overflow brought on by heart failure may also result in fibrosis.

genetic disorders
Myocardial fibrosis can result from some genetic disorders that people are born with. These circumstances include:

cardiomyopathy with hypertrophy
Fabry illness
Pompe illness
Toxicity
Some drugs, including those used in chemotherapy, can harm your heart and result in the formation of scar tissue.

Some environmental pollutants that interfere with your hormone levels may also worsen fibrosis. Evidence suggests that the chemical bisphenol-A (BPA) may cause cardiac fibrosis in rodents, according to a 2021 mouse study.

Inflammation
Some circumstances that cause inflammation can result in the production of scar tissue. These circumstances include:

infections
myocarditis sarcoidosis
Myocardial fibrosis diagnosis
In most cases, an echocardiography is the first test used to diagnose cardiac fibrosis. During this examination, sound waves are used to take pictures of your heart while it beats and pumps blood throughout your body. The echocardiography enables medical professionals to assess your heart’s efficiency and aids in the detection of any muscle or valve problems.

A doctor can then recommend an MRI scan of your heart if an echocardiogram reveals a weakening of the muscle or other signs of fibrosis.

Myocardial fibrosis can currently be diagnosed via an imaging method known as a “cardiovascular magnetic resonance (CMR) scan” (MRI). A CMR evaluates the structure of your heart and blood arteries using magnetic and radio waves.

Two methods for CMR image enhancementTrusted sources are crucial in fibrosis diagnosis. A CMR technique that can be used to look for replacement fibrosis is late gadolinium enhancement. Interstitial fibrosis can be detected using the CMR techniques T1 mapping and extracellular volume fraction.

myocardial fibrosis treatment
The primary focus of myocardial fibrosis treatment is addressing the underlying causes. For instance, heart attack therapiesSome reliable sources are:

angioplasty, stent implantation, and bypass surgery
atherectomy
Other heart diseases and their complications may be treated with:

heart valve replacement
Aortic valve replacement using transcatheter means (TAVR) for damaged aortic valves
revascularization of the transmyocardium
ablation with radio frequency
heart transplant after cardiomyoplasty
Although there is no prescription that particularly treats myocardial fibrosis, many people gain from drugs that address low ejection fraction and decreased cardiac function. These drugs often consist of:

beta-blockers
inhibitors of the angiotensin converting enzyme (ACE)
ARBs and ARNIs are drugs that prevent the action of the hormone angiotensin II on the receptor for neprilysin.
Researchers are still looking at the possibility of using drugs to dissolve heart scar tissue. The Food and Drug Administration (FDA) has not yet authorized the use of any antifibrotic drugs. The following medications are being looked into:

Inhibitors of the renin-angiotensin-aldosterone system and anti-inflammatory drugs
growing element that transforms Matrix metalloproteinase (MMP) inhibitors and beta signaling inhibitors
Modulators of the beta 3 adrenergic receptor
(CAR) chimeric antigen receptor T-cell treatment
Outlook for myocardial fibrosis
The severity of myocardial fibrosis, which is a side effect of numerous different heart disorders, can range from minor to severe. People with less severe scarring typically have a better prognosis for myocardial fibrosis.

Interstitial fibrosis may be curable with early therapy, according to research, however myocardial fibrosis is a poor prognostic indicator.For those with chronic heart failure, a reliable source.

Aortic valve replacement patients with fibrosis had a 27% higher risk of dying from cardiovascular causes than patients without fibrosis, according to a 2018 10-year study.

Takeaway
Myocardial fibrosis is cardiac scarring brought on by several forms of heart disease. It may cause heart failure by impairing your heart’s capacity to contract normally.

Currently, treating the underlying heart condition is essentially how myocardial fibrosis is treated. Therapies to remove scar tissue from the heart are being researched by researchers. Myocardial fibrosis-specific medicines have not yet received FDA approval, however several studies have produced encouraging outcomes.