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
Year: 2019
Type: article
Abstract: 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.
DOI: 10.1002/ejhf.1406
Authors: Rudolf A. de Boer, Gilles De Keulenaer, Johann Bauersachs, Dirk Brutsaert, John G. Cleland, Javier Diez, Xiao-Jun Du, Paul Ford, Frank R. Heinzel, Kenneth E. Lipson, Theresa McDonagh, Natalia Lopez-Andres, Ida G. Lunde, Alexander R. Lyon, Piero Pollesello, Sanjay K. Prasad, Carlo G. Tocchetti, Manuel Mayr, Joost P.G. Sluijter, Thomas Thum, Carsten Tschöpe, Faiez Zannad, Wolfram-Hubertus Zimmermann, Frank Ruschitzka, Gerasimos Filippatos, Merry L. Lindsey, Christoph Maack, Stephane Heymans
Institutions: University Medical Center Groningen, University of Groningen, University of Antwerp, Medizinische Hochschule Hannover, University of Glasgow, Clinica Universidad de Navarra, Centro de Investigación Médica Aplicada, Universidad de Navarra, Baker Heart and Diabetes Institute, Galecto (Denmark), Charité – Universitätsmedizin Berlin, FibroGen (United States), King's College Hospital, Universidad Pública de Navarra (UPNA), Complejo Hospitalario de Navarra, Navarrabiomed, Oslo University Hospital, University of Oslo, Institutt for Eksperimentell Medisinsk Forskning, Royal Brompton Hospital, Imperial College London, Orion Corporation (Finland), Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Federico II University Hospital, University of Naples Federico II, University of London, King's College London, Utrecht University, University Medical Center Utrecht, German Centre for Cardiovascular Research, Research Center for Translational Regenerative Medicine, Centre Hospitalier Régional et Universitaire de Nancy, French Clinical Research Infrastructure Network, Universitätsmedizin Göttingen, University Hospital Zurich, National and Kapodistrian University of Athens, University General Hospital Attikon, University of Mississippi Medical Center, G.V. (Sonny) Montgomery VA Medical Center, University of Würzburg, Universitätsklinikum Würzburg, Maastricht University, Netherlands Heart Institute, KU Leuven
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,300
Funders: U.S. Department of Veterans Affairs, Amgen, Bristol-Myers Squibb, Pfizer, Alere, Abiomed, British Heart Foundation, European Commission, Rosetrees Trust, Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Federalno Ministarstvo Obrazovanja i Nauke, Servier, European Research Area Network on Cardiovascular Diseases, Horizon 2020 Framework Programme, National Heart, Lung, and Blood Institute, Daiichi Sankyo Europe, H2020 European Research Council, Cilag
Awards: G1171311887, G1268760606, G1567991199, G1730292437, G23728244, Systems Biology of Macrophage Polarizaiton Following Myocardial Infarction, G2887328572, G3039888125, G3421341489, G3695737315, Targeting cardiac fibrosis for heart failure treatment, Systems Biology of Fibroblast Activation Following Myocardial Infarction, Is it safe to withdraw medical therapy from patients with a previous diagnosis of dilated cardiomyopathy, now in remission?, G434337789, G4386296807, Hepatic and Cardiac Toxicity Systems modelling, G4695049415, G4763622169, G5296781981, The BHF Chair of Cardiovascular Proteomics, G615556488, Exploring known and novel biomarkers of cardiovascular disease, G6465052431, G6537201639, Assessment of coronary haemodynamics and the mechanisms of perfusion abnormalities and chest pain in hypertrophic cardiomyopathy, G7677519857, Heart OMics in AGEing, ERA-CVD 'transnational research projects on cardiovascular diseases': non-coding RNAs in cardiac macrophages and their role in heart failure
OpenAlex ID: W2912308947