Nordic Bioscience, Biomarkers and Research, Herlev, Denmark.
Labratory of Molecular Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
Matrix Biol. 2020 Sep;91-92:188-203. doi: 10.1016/j.matbio.2020.03.005. Epub 2020 Mar 20.
The involvement of fibrosis as an underlying pathology in heart diseases is becoming increasingly clear. In recent years, fibrosis has been granted a causative role in heart diseases and is now emerging as a major contributor to Atrial Fibrillation (AF) pathogenesis. AF is the most common arrhythmia encountered in the clinic, but the substrate for AF is still being debated. Consensus in the field is a combination of cardiac tissue remodeling, inflammation and genetic predisposition. The extracellular matrix (ECM) is subject of growing investigation, since measuring circulatory biomarkers of ECM formation and degradation provides both diagnostic and prognostic information. However, fibrosis is not just fibrosis. Each specific collagen biomarker holds information on regulatory mechanisms, as well as information about which section of the ECM is being remodeled, providing a detailed description of cardiac tissue homeostasis. This review entails an overview of the implication of fibrosis in AF, the different collagens and their significance, and the potential of using biomarkers of ECM remodeling as tools for understanding AF pathogenesis and identifying patients at risk for further disease progression.
纤维化作为心脏病的潜在病理学越来越明显。近年来，纤维化在心脏病中的作用已被确定，并成为心房颤动（AF）发病机制的主要因素。AF 是临床上最常见的心律失常，但 AF 的发病基础仍存在争议。该领域的共识是心脏组织重构、炎症和遗传易感性的结合。细胞外基质（ECM）是研究的重点，因为测量 ECM 形成和降解的循环生物标志物可提供诊断和预后信息。然而，纤维化并不仅仅是纤维化。每种特定的胶原蛋白生物标志物都提供了关于调节机制的信息，以及关于 ECM 的哪个部分正在进行重塑的信息，从而提供了对心脏组织动态平衡的详细描述。这篇综述概述了纤维化在 AF 中的作用、不同的胶原蛋白及其意义，以及将 ECM 重塑生物标志物用作了解 AF 发病机制和识别有进一步疾病进展风险的患者的工具的潜力。
