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[Myocardial fibrosis--the theoretical bases, clinical aspects and therapeutic implications]
1Serviço de Cardiologia, UTIC-Arsénio Cordeiro, Hospital de Santa Maria, Lisboa.
Insights
This review explores myocardial fibrosis and cardiac remodeling, focusing on the collagen network and the renin-angiotensin-aldosterone system. It examines therapeutic strategies for heart conditions like hypertension and ischemic heart disease.
Area of Science:
- Cardiovascular Biology
- Connective Tissue Research
Context:
- Focuses on the myocardial collagen network and its dynamic processes.
- Analyzes myocardial fibrosis and cardiac remodeling in various pathological states.
Purpose:
- To review current knowledge on myocardial structure, collagen metabolism, and fibrosis.
- To explore the role of the renin-angiotensin-aldosterone system in cardiac remodeling.
- To discuss the therapeutic implications of targeting fibrosis and remodeling.
Summary:
- Reviews myocardial structure, emphasizing collagen network dynamics, degradation, and synthesis.
- Examines myocardial fibrosis and cardiac remodeling in ventricular hypertrophy, hypertension, ischemic heart disease, and aging.
- Discusses the renin-angiotensin-aldosterone system's role and the effects of ACE inhibitors and aldosterone antagonists in animal models.
Impact:
- Provides insights into the mechanisms of cardiac remodeling and fibrosis.
- Highlights potential therapeutic targets for cardiovascular diseases.
- Discusses clinical and therapeutic implications for human treatment strategies.
Abstract:
A review on the present knowledges of the myocardial structure, with particular emphasis on the collagen network and its degradation/synthesis process was performed. Myocardial fibrosis and cardiac remodeling concepts are analysed, explaining them in the context of ventricular hypertrophy, arterial hypertension, myocardial remodeling in ischemic heart disease and cardiac remodeling in the aged. We also review the role of the renin-angiotensin-aldosterone system in myocardial fibrosis, as well as the results of preventing action of angiotensin converting enzyme inhibitors and aldosterone antagonists in myocardial fibrosis and consequent cardiac remodeling in the animal experimentation. Clinical and therapeutic implications of this knowledge are discussed as well as therapeutic implication in man, in view of recent studies.