Τίτλος:
Towards better definition, quantification and treatment of fibrosis in heart failure. A scientific roadmap by the Committee of Translational Research of the Heart Failure Association (HFA) of the European Society of Cardiology
Περίληψη:
Fibrosis is a pivotal player in heart failure development and progression. Measurements of (markers of) fibrosis in tissue and blood may help to diagnose and risk stratify patients with heart failure, and its treatment may be effective in preventing heart failure and its progression. A lack of pathophysiological insights and uniform definitions has hampered the research in fibrosis and heart failure. The Translational Research Committee of the Heart Failure Association discussed several aspects of fibrosis in their workshop. Early insidious perturbations such as subclinical hypertension or inflammation may trigger first fibrotic events, while more dramatic triggers such as myocardial infarction. and myocarditis give rise to full blown scar formation and ongoing fibrosis in diseased hearts. Aging itself is also associated with a cardiac phenotype that includes fibrosis. Fibrosis is an extremely heterogeneous phenomenon, as several stages of the fibrotic process exist, each with different fibrosis subtypes and a different composition of various cells and proteins — resulting in a very complex pathophysiology. As a result, detection of fibrosis, e.g. using current cardiac imaging modalities or plasma biomarkers, will detect only specific subforms of fibrosis, but cannot capture all aspects of the complex fibrotic process. Furthermore, several anti-fibrotic therapies are under investigation, but such therapies generally target aspecific aspects of the fibrotic process and suffer from a lack of precision. This review discusses the mechanisms and the caveats and proposes a roadmap for future research. © 2019 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Συγγραφείς:
de Boer, R.A.
De Keulenaer, G.
Bauersachs, J.
Brutsaert, D.
Cleland, J.G.
Diez, J.
Du, X.-J.
Ford, P.
Heinzel, F.R.
Lipson, K.E.
McDonagh, T.
Lopez-Andres, N.
Lunde, I.G.
Lyon, A.R.
Pollesello, P.
Prasad, S.K.
Tocchetti, C.G.
Mayr, M.
Sluijter, J.P.G.
Thum, T.
Tschöpe, C.
Zannad, F.
Zimmermann, W.-H.
Ruschitzka, F.
Filippatos, G.
Lindsey, M.L.
Maack, C.
Heymans, S.
Λέξεις-κλειδιά:
biological marker; CD68 antigen; collagen; connective tissue growth factor; galectin 3; gelatinase B; glycoprotein; interleukin 1; interleukin 10; interleukin 11; macrophage elastase; mimecan; monocyte chemotactic protein 1; myeloperoxidase; osteopontin; procollagen type 3 aminopropeptide; protein lysine 6 oxidase; proteoglycan; receptor type tyrosine protein phosphatase C; stromelysin; stromelysin 3; syndecan; thrombospondin; tissue inhibitor of metalloproteinase 1; tissue inhibitor of metalloproteinase 3; transcription factor RUNX2; transforming growth factor beta; biological marker; scleroprotein, aging; cardiac imaging; cardiomyopathy; cardiovascular magnetic resonance; disease classification; echocardiography; extracellular matrix; genetics; heart failure; heart failure with preserved ejection fraction; heart infarction; heart left ventricle overload; heart muscle fibrosis; hemodynamics; human; hypertension; nonhuman; phenotype; priority journal; Review; screening; blood; cardiac muscle; classification; disease management; Europe; fibrosis; heart failure; medical society; metabolism; pathology; pathophysiology; procedures; prognosis; research; translational research, Biomarkers; Cardiac Imaging Techniques; Disease Management; Europe; Extracellular Matrix Proteins; Fibrosis; Heart Failure; Humans; Myocardium; Prognosis; Research; Societies, Medical; Translational Medical Research
