Caulfield J B, Janicki J S
Department of Pathology, University of Alabama at Birmingham, USA.
Technol Health Care. 1997 Apr;5(1-2):95-113.
The extracellular collagen matrix of the myocardium plays an important role in maintaining muscle fiber and cardiac alignment and ventricular shape and size. It also influences tissue and ventricle stiffness. This network consists of an organized hierarchy of collagen that is intimately associated with individual and groups of myocyte and muscle fibers, as well as the coronary vasculature. In renovascular and genetic hypertension, the hypertrophic response of the myocardium includes an increase in collagen concentration, thickening of existing fibrillar collagen, and addition of newly synthesized collagen to all of the matrix components. The consequences of this remodeling are a stiffer myocardium and left ventricular diastolic dysfunction. With removal of less than half of the normal amount of collagen the opposite occurs. That is, the ventricle dilates and there is an increase in ventricular compliance. Thus an abnormal accumulation of collagen is a major distinguishing factor between physiologic and pathologic hypertrophy while an abrupt decrease in collagen concentration results in a ventricular remodeling similar to that of a heart in failure.
心肌的细胞外胶原基质在维持肌纤维、心脏排列以及心室形状和大小方面发挥着重要作用。它还会影响组织和心室的僵硬度。这个网络由有组织层次的胶原组成，与单个心肌细胞、成组的肌纤维以及冠状血管系统密切相关。在肾血管性高血压和遗传性高血压中，心肌的肥厚反应包括胶原浓度增加、现有纤维状胶原增粗以及向所有基质成分中添加新合成的胶原。这种重塑的后果是心肌更僵硬以及左心室舒张功能障碍。去除不到正常量一半的胶原时则会出现相反的情况。也就是说，心室扩张且心室顺应性增加。因此，胶原的异常积聚是生理性和病理性肥大的主要区别因素，而胶原浓度的突然降低会导致类似于心力衰竭心脏的心室重塑。
