Abstract
The cardiac extracellular matrix (ECM) is the dynamic interstitial scaffolding environment that plays an important role in optimal cardiac function. The strength of the cardiac ECM is known to confer significant protection against myocardial rupture, and the elasticity supports cardiomyocyte contractile function. Upon haemodynamic or ischemic stress, ECM remodeling occurs and is now well established to play a role in the progression of heart disease. Increased turnover of ECM is promoted when resident fibroblasts differentiate into the active myofibroblast phenotype. Although ECM remodeling can be initially beneficial under some circumstances, prolonged and extensive fibrosis is typically associated with decreased contractility, diastolic dysfunction and poor clinical outcome. In this chapter we review the structure and function of the cardiac ECM from development to various pathological states. We will also discuss the role of fibroblasts and the activation of myofibroblasts as well as highlight new findings in the study of reverse cardiac remodelling following unloading of the left ventricle.
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Dadson, K., Kovacevic, V., Sweeney, G. (2015). Mechanisms of Cardiac Fibrosis and Heart Failure. In: Dixon, I., Wigle, J. (eds) Cardiac Fibrosis and Heart Failure: Cause or Effect?. Advances in Biochemistry in Health and Disease, vol 13. Springer, Cham. https://doi.org/10.1007/978-3-319-17437-2_15
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