Molecular Analysis of Epigenetic Modification Process in Distressed Cardiomyocytes May Explor Indication of Mitral Valve Surgery for Advanced Heart Failure Associated With Non-ischemic Dilated Cardiomyopath

Introduction: Mitral valve (MV) surgery for functional mitral regurgitation (MR) associated with advanced heart failure (HF) is a surgical challenge with surgical indication not clearly established. It was recently reported that the epigenetic modification, such as methylation or acetylation of histone H3, is closely related to functional reversibility of cardiomyocytes in advanced HF. Hypothesis: We herein hypothesized that epigenetic profiles in the left ventricle (LV) may be associated with clinical outcome of MV surgery for non-ischemic dilated cardiomyopathy (NIDCM)-causing advanced HF. Methods: Thirteen patients diagnosed as having NIDCM underwent chordal sparing MV replacement for severe MR associated with low ejection fraction (EF) (u003c35%) between 2012 and 2015. Intraoperatively biopsied LV tissue was immunohistologically labeled by histone H3 lysine 9 tri-methylation (H3K9me3) and acetylation (H3K9ac), and then the scores ranging from 0 to 12 were assigned as intensity and percentage of positive s...