{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T20:16:19Z","timestamp":1769112979268,"version":"3.49.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Heart Fail"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Mechanical unloading by ventricular assist devices (VADs) has become increasingly important for the therapy of end\u2010stage heart failure during the last decade. However, VAD support was claimed to be associated with partial reverse remodelling. Unfortunately, the literature describes the contradictory effects of VAD systems on cardiac fibrosis, a hallmark of cardiac remodelling. To clarify these inconsistent results, the effects on cardiac fibrosis before and after mechanical unloading in 125 patients were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      Left ventricular myocardial tissue from ischaemic or non\u2010ischaemic cardiomyopathy patients undergoing VAD implantation and subsequent cardiac transplantation and non\u2010failing hearts of the control group were analysed for 4\u2010hydroxyproline (4OH\u2010P) content as a marker for collagen protein. In addition, collagen cross\u2010linking and mRNAs of collagens I and III and transforming growth factor beta\u20101 were measured. 4OH\u2010P content was significantly increased in failing hearts compared with the control group and increased (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) after mechanical unloading (nmol\/mg tissue, mean\u2009\u00b1\u2009standard deviation: 16.74\u2009\u00b1\u20099.68 vs. 7.75\u2009\u00b1\u20092.39 and 18.57\u2009\u00b1\u20099.19). However, plotting of the 4OH\u2010P ratios (post\/pre\u2010VAD) against the collagen content pre\u2010VAD could be fitted by non\u2010linear regression. Collagen cross\u2010linking correlated strongly with the total collagen content in pre\u2010 and post\u2010VAD myocardium (r\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00.73 and 0.71, respectively). In contrast to the total collagen content, all three mRNAs of fibrotic genes were significantly down\u2010regulated during VAD support when compared to pre\u2010VAD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This investigation of a comparably large patient cohort revealed that cardiac fibrosis was strongly increased in heart failure and increased even after mechanical unloading. The mRNAs of collagens I and III are independently regulated from the collagen protein.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2021","type":"journal-article","created":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T12:15:06Z","timestamp":1602332106000},"page":"324-334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Mechanical circulatory support does not reduce advanced myocardial fibrosis in patients with end\u2010stage heart failure"],"prefix":"10.1093","volume":"23","author":[{"given":"Astrid","family":"Kassner","sequence":"first","affiliation":[{"name":"Erich &amp; Hanna Klessmann Institute for Cardiovascular Research &amp; Development (EHKI), Heart &amp; Diabetes Center NRW University Hospital of the Ruhr\u2010University Bochum  Bad Oeynhausen 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Ruhr\u2010University Bochum  Bad Oeynhausen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"G\u00e4rtner","sequence":"additional","affiliation":[{"name":"Erich &amp; Hanna Klessmann Institute for Cardiovascular Research &amp; Development (EHKI), Heart &amp; Diabetes Center NRW University Hospital of the Ruhr\u2010University Bochum  Bad Oeynhausen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Tiesmeier","sequence":"additional","affiliation":[{"name":"Hospital Luebbecke\u2010Rhaden, Muehlenkreis Hospitals Medical\u2010Campus OWL of the Ruhr\u2010University Bochum  Luebbecke Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Fox","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Heart &amp; Diabetes Center NRW University Hospital of the Ruhr\u2010University Bochum  Bad Oeynhausen 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