PRIMARY AND SECONDARY (INDUCED) IMMOBILIZING INTERSTITIAL CARDIAC FIBROSIS
Fibrosis of the heart may reflect the activation of reparative or maladaptive processes. When the regulation of collagen fiber synthesis is disrupted, the volume of the interstitial space increases, the interstitial connective tissue changes qualitatively (its density increases, the structure of the "braiding” changes, the location of the fibers changes, etc.) - this often causes cardiac dysfunction: there is mechanical compression of healthy cardiomyocytes from the outside, restriction of their normal movement and functioning. The article presents two clinical observations that demonstrate an example of primary and secondary (induced) immobilizing interstitial cardiac fibrosis. Primary immobilizing interstitial cardiac fibrosis is based on changes in connective tissue, without initial damage to cardiomyocytes. The development of the disease occurs gradually, starting with a slight increase in the volume of the interstitium, up to the formation of gross fibrosis with compression of arterioles. Secondary (induced) immobilizing interstitial cardiac fibrosis is based on the process of diffuse changes in the interstitial connective tissue as a result of stimulation by its formed postinfarction scars.