Focusing Heart Failure Research on Myocardial Fibrosis to Prioritize Translation.

Area of Science:

• Cardiology
• Biomedical Research

Background:

• Heart failure (HF) is traditionally defined by symptoms, but distinct classifications like HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) have prognostic and therapeutic importance.
• HFrEF involves reduced left ventricular systolic function, while HFpEF involves abnormal left ventricular filling (diastolic dysfunction).
• HF is a significant issue within the US Department of Veterans Affairs (VA), representing a major research priority.

Purpose of the Study:

• To explore the myocardial extracellular matrix as a potential therapeutic target for both HFrEF and HFpEF.
• To identify common modifiable pathways and biological mediators shared by different forms of HF.
• To propose specific research directions for targeting myocardial fibrosis in heart failure.

Main Methods:

• A conference titled "Targeting Myocardial Fibrosis in Heart Failure" was convened, sponsored by the VA.
• The conference explored the hypothesis that HFrEF and HFpEF, despite distinct mechanisms, may share common pathways.
• Discussions focused on inflammation and extracellular matrix as converging themes.

Main Results:

• Inflammation and extracellular matrix changes were identified as major converging themes in both HFrEF and HFpEF.
• The extracellular matrix is proposed as a potential common therapeutic target.
• Specific research opportunities and unmet challenges were discussed.

Conclusions:

• Myocardial fibrosis, involving extracellular matrix changes, is a potential common therapeutic target for different forms of heart failure.
• Further research is needed to explore inflammation and extracellular matrix modulation as strategies to mitigate HF morbidity and mortality.
• Targeting shared pathways offers a promising avenue for developing novel treatments for the broad spectrum of heart failure patients.