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Cardiac Fibrosis in heart failure: Focus on non-invasive diagnosis and emerging therapeutic strategies

Ravassa, Susana; Lopez, Begona; Treibel, Thomas A; San Jose, Gorka; Losada-Fuentenebroa, Blanca; Tapia, Leire; Bayes-Genis, Antoni; ... Gonzalez, Arantxa; + view all (2023) Cardiac Fibrosis in heart failure: Focus on non-invasive diagnosis and emerging therapeutic strategies. Molecular Aspects of Medicine , 93 , Article 101194. 10.1016/j.mam.2023.101194. Green open access

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Abstract

Heart failure is a leading cause of mortality and hospitalization worldwide. Cardiac fibrosis, resulting from the excessive deposition of collagen fibers, is a common feature across the spectrum of conditions converging in heart failure. Eventually, either reparative or reactive in nature, in the long-term cardiac fibrosis contributes to heart failure development and progression and is associated with poor clinical outcomes. Despite this, specific cardiac antifibrotic therapies are lacking, making cardiac fibrosis an urgent unmet medical need. In this context, a better patient phenotyping is needed to characterize the heterogenous features of cardiac fibrosis to advance toward its personalized management. In this review, we will describe the different phenotypes associated with cardiac fibrosis in heart failure and we will focus on the potential usefulness of imaging techniques and circulating biomarkers for the non-invasive characterization and phenotyping of this condition and for tracking its clinical impact. We will also recapitulate the cardiac antifibrotic effects of existing heart failure and non-heart failure drugs and we will discuss potential strategies under preclinical development targeting the activation of cardiac fibroblasts at different levels, as well as targeting additional extracardiac processes.

Type: Article
Title: Cardiac Fibrosis in heart failure: Focus on non-invasive diagnosis and emerging therapeutic strategies
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.mam.2023.101194
Publisher version: https://doi.org/10.1016/j.mam.2023.101194
Language: English
Additional information: © 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Keywords: Science & Technology, Life Sciences & Biomedicine, Biochemistry & Molecular Biology, Medicine, Research & Experimental, Research & Experimental Medicine, Fibrosis, Heart failure, Fibroblasts, Collagen, Circulating biomarkers, Cardiac magnetic resonance, Therapy, CARDIOVASCULAR MAGNETIC-RESONANCE, MYOCARDIAL EXTRACELLULAR VOLUME, SEVERE AORTIC-STENOSIS, LEFT-VENTRICULAR HYPERTROPHY, PRESERVED EJECTION FRACTION, FIBROBLAST ACTIVATION PROTEIN, CORONARY-ARTERY-DISEASE, COLLAGEN CROSS-LINKING, ANGIOTENSIN-II, DIASTOLIC DYSFUNCTION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/10180315
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