Quantitative Assessment of Myocardial Fibrosis and Right Ventricular Remodeling in Chronic Obstructive Pulmonary Disease: A Post-Mortem Human Study

International Journal of Anatomy and Physiology | Vol. 15, No. 9, September 2026 | pp. 062–073

DOI: 10.46882/2026/IJAP/000173

Article Type: Original Research Article

Title: Quantitative Assessment of Myocardial Fibrosis and Right Ventricular Remodeling in Chronic Obstructive Pulmonary Disease: A Post-Mortem Human Study

Names of Authors: Alistair G. Vance¹, Fiona M. Campbell²

Authors’ Affiliations: ¹Department of Pathology and Anatomy, University of Edinburgh Medical School, Edinburgh, United Kingdom; ²School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom

Abstract:
Chronic obstructive pulmonary disease (COPD) induces significant pulmonary hypertension, leading to secondary structural changes in the heart, collectively known as cor pulmonale. This study provides a post-mortem quantitative analysis of right ventricular (RV) remodeling and interstitial myocardial fibrosis in patients diagnosed with severe COPD. Autopsy heart specimens from 45 individuals deceased due to complications of COPD and 45 age-matched control subjects who died of non-cardiopulmonary causes were analyzed. Tissue sections from the RV free wall, interventricular septum (IVS), and left ventricular (LV) free wall were processed and stained with Masson’s trichrome. The collagen volume fraction (CVF) was determined using digital image analysis software to quantify interstitial fibrosis. The mean thickness of the RV free wall in the COPD group was significantly elevated compared to the control group (6.8 ± 0.9 mm vs 3.4 ± 0.4 mm, p < 0.001). The CVF in the RV free wall of COPD specimens was significantly higher than in controls (8.4 ± 1.2% vs 2.1 ± 0.5%, p < 0.001). Interestingly, the IVS also demonstrated a significant increase in CVF (5.9 ± 0.8% vs 2.3 ± 0.4%, p < 0.01), whereas the LV free wall displayed no significant alterations in fibrosis. These findings demonstrate that severe COPD causes profound, chamber-specific structural remodeling characterized by robust RV hypertrophic compensation and concurrent interstitial fibrosis, which alters cardiac tissue compliance.

Keywords: Myocardial Fibrosis, Right Ventricular Hypertrophy, COPD, Post-Mortem, Collagen Volume Fraction

Manuscript Timeline: Received: June 11, 2026; Revised: July 22, 2026; Accepted: August 11, 2026; Published: September 04, 2026

Citation: Vance A.G., & Campbell F.M. (2026). Quantitative Assessment of Myocardial Fibrosis and Right Ventricular Remodeling in Chronic Obstructive Pulmonary Disease: A Post-Mortem Human Study. International Journal of Anatomy and Physiology, 15(9), 062–073. DOI: 10.46882/2026/IJAP/000173

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