Assessment of Nonischemic Myocardial Fibrosis

Christine Jellis, Jennifer Martin, Jagat Narula, Thomas H. Marwick

Research output: Contribution to journalReview articlepeer-review

212 Scopus citations

Abstract

Myocardial fibrosis is recognized as the pathologic entity of extracellular matrix remodeling. Diffuse, reactive fibrosis is being increasingly recognized in a variety of conditions despite the absence of ischemia. Regardless of the etiology, fibrosis leads to increased myocardial stiffness thereby promoting cardiac dysfunction. This may present clinically with symptoms of cardiac failure although often this is a subclinical disease. Various imaging modalities and collagen biomarkers have been used as surrogate markers to assess the presence, extent, and turnover of myocardial fibrosis. Techniques using echocardiography, cardiac magnetic resonance, and nuclear imaging have been developed to detect early features of systolic and diastolic left ventricular dysfunction and impaired contractile reserve. Further identification of diffuse reactive fibrosis may be possible with evolving cardiac magnetic resonance and molecular techniques. The goal of these approaches is to enable targeted therapy to be instituted earlier, leading to prevention of disease progression and fibrosis accumulation long term.

Original languageEnglish
Pages (from-to)89-97
Number of pages9
JournalJournal of the American College of Cardiology
Volume56
Issue number2
DOIs
StatePublished - 6 Jul 2010
Externally publishedYes

Keywords

  • fibrosis
  • heart failure
  • myocardial

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