BaniHani Hasan A, Khaled Lana H, Al Sharaa Nada M, Al Saleh Raghad A, Bin Ghalaita Ahmad K, Bin Sulaiman Ahmad S, Holeihel Ahmad
Medicine and Surgery, University of Sharjah, Sharjah, ARE.
Family Medicine, University Hospital Sharjah, Sharjah, ARE.
Cureus. 2025 Mar 27;17(3):e81264. doi: 10.7759/cureus.81264. eCollection 2025 Mar.
Cardiac fibrosis, characterized by excessive extracellular matrix deposition, contributes to heart failure, arrhythmias, and myocardial dysfunction. Despite advances in understanding its mechanisms, targeted antifibrotic therapies remain limited. This review examines the causes, molecular mechanisms, diagnostic approaches, and therapeutic strategies for cardiac fibrosis. A systematic review of peer-reviewed studies was conducted, focusing on the etiology, diagnosis, treatment, and prognosis of cardiac fibrosis with no specific timeframe. The condition is driven by fibroblast activation, inflammatory pathways, and mechanical stress, with key contributing factors including ischemic heart disease, hypertension, diabetes, and aging. Diagnostic tools such as cardiac magnetic resonance imaging with T1 mapping and biomarkers play a crucial role, with natriuretic peptides offering both diagnostic and prognostic value. Galectin-3 has also shown promise as a prognostic marker. Current therapies, including RAAS inhibitors and beta-blockers, help prevent fibrosis progression but do not reverse established fibrosis. Emerging strategies such as plant-based compounds, gene therapy, fibroblast-targeting vaccines, and stem cell reprogramming show potential in preclinical studies. However, cardiac fibrosis remains a major driver of heart disease progression, and existing treatments remain limited. Major gaps include the lack of validated antifibrotic agents and challenges in translating preclinical findings into clinical applications. Further research is essential to develop effective targeted interventions.
心脏纤维化以细胞外基质过度沉积为特征，可导致心力衰竭、心律失常和心肌功能障碍。尽管在了解其机制方面取得了进展，但靶向抗纤维化治疗仍然有限。本综述探讨了心脏纤维化的病因、分子机制、诊断方法和治疗策略。我们对同行评审的研究进行了系统综述，重点关注心脏纤维化的病因、诊断、治疗和预后，没有设定具体的时间范围。这种疾病由成纤维细胞活化、炎症途径和机械应力驱动，主要促成因素包括缺血性心脏病、高血压、糖尿病和衰老。心脏磁共振成像T1映射和生物标志物等诊断工具发挥着关键作用，利钠肽具有诊断和预后价值。半乳糖凝集素-3也显示出作为预后标志物的潜力。目前的治疗方法，包括肾素-血管紧张素-醛固酮系统（RAAS）抑制剂和β受体阻滞剂，有助于预防纤维化进展，但不能逆转已形成的纤维化。植物性化合物、基因治疗、靶向成纤维细胞的疫苗和干细胞重编程等新兴策略在临床前研究中显示出潜力。然而，心脏纤维化仍然是心脏病进展的主要驱动因素，现有治疗方法仍然有限。主要差距包括缺乏经过验证的抗纤维化药物，以及将临床前研究结果转化为临床应用面临的挑战。进一步的研究对于开发有效的靶向干预措施至关重要。
