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Myocardial fibrosis: a defense mechanism or main cause of adverse outcomes?

Authors: Troshin D.S., Averina I.I., Aleksandrova S.A., Marchenko D.S., Donakanyan S.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2023-17-4-464-473

For citation: Troshin D.S., Averina I.I., Aleksandrova S.A., Marchenko D.S., Donakanyan S.A. Myocardial fibrosis: a defense mechanism or main cause of adverse outcomes? Creative Cardiology. 2023; 17 (4): 464–73 (in Russ.). DOI: 10.24022/1997-3187-2023-17-4-464-473

Received / Accepted:  29.08.2023 / 07.11.2023

Keywords: myocardial fibrosis cardiac fibrosis extracellular matrix diagnosis of myocardial fibrosis treatment of myocardial fibrosis fibrosis biomarkers

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Abstract

Myocardial fibrosis is associated with the most cardiovascular diseases. Based on the pathological process, the excessive accumulation of extracellular matrix components may not only serve as a defense mechanism, but also lead to the worsening disease course and heart failure progression, indicating poor prognosis. The basics of physiology and biochemistry of the extracellular matrix, both normally and in various pathological conditions are discussed in this article. Diagnostic issues including non-invasive methods for quantification both focal and diffuse fibrosis as well as potential biomarkers of myocardial fibrosis are described in detail. The use of myocardial fibrosis assessment in early risk stratification in patients with various cardiovascular diseases and a review of meta-analyses on this topic is presented. Thus, therapeutic options aimed to affect extracellular matrix as as well as personalised management strategies, described in the article, appear to be essencial to improve clinical state and outcomes of cardiovascular diseases.

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About Authors

  • Dmitriy S. Troshin, Postgraduate, Cardiologist; ORCID
  • Irina I. Averina, Dr. Med. Sci., Professor, Senior Researcher, Cardiologist; ORCID
  • Svetlana A. Aleksandrova, Cand. Med. Sci., Senior Researcher, Radiologist; ORCID
  • Darya S. Marchenko, Postgraduate, Radiologist; ORCID
  • Sergey A. Donakanyan, Dr. Med. Sci., Professor, Cardiovascular Surgeon; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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