Cardiac remodeling and failure
Abstract
Once considered an inert physical scaffolding, the extracellular matrix (ECM) is increasingly being appreciated as a central structural support and dynamic signaling system for cells to assemble into functional tissues. The ECM can respond to environmental stimuli and tissue injury by altering its abundance, composition, and spatial organization, with profound consequences on the structure and function of the tissues that it inhabits. ECM remodeling is now recognized as a central process underlying the maladaptive reorganization of cardiac size, shape, and function during the progression of CHF. ECM remodeling is largely determined by the balance of degradative enzymes, the MMPs, with respect to a highly regulated and complex assortment of multifunctional endogenous inhibitors, the TIMPs. Clinical studies over the past decade document increased MMP activities associated with diseased hearts. Animal models of cardiovascular disease, as well as transgenic mouse models, further support a role for MMPs in cardiac remodeling. Similarly, clinical, experimental, and genetic approaches implicate the involvement of TIMPs in heart disease, and TIMP expression is selectively reduced in the failing heart. The four known TIMP species are differentially regulated in the heart, and their specific role during the progression of CHF is not clear. Unique among TIMPs, TIMP-3 is ECM bound, highly expressed in the heart, uniformly reduced in failing hearts, and a potent endogenous inhibitor of MMPs and A Disintegrin and metalloproteinase (ADAMs) implicated in cardiac disease. The control of ECM remodeling in the failing heart may provide a missing link in our currently inadequate armamentarium of treatments for patients with CHF, and a better understanding of the complex role of TIMP proteins in the normal and failing myocardium, particularly the unique role of TIMP-3, may facilitate the development of targeted anti-remodeling strategies.
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Alterations in the composition and structure of the extracellular matrix can make an important contribution to changes in cardiac size, structure, and function in heart failure.
“Alterations in the composition and structure of the extracellular matrix (ECM) can make an important contribution to changes in the cardiac size, structure, and function in heart failure (98, 237).”
From Cardiac remodeling in obesity (2008) · cites this paper as [98]
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SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review
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- Authors
- Fedak, P. W. M., Verma, S., Weisel, R. D., & Li, R.-K.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Fedak, Paul W.M.
- Venue
- Cardiovascular Pathology
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 14
- Issue
- 2
- Pages
- 49-60
- ISSN
- 1054-8807 (ISSN-L)
- OpenAlex
- W3118906554
- Cited by
- 120
- References
- 116
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 5 · 2014: 3 · 2013: 3 · 2012: 9
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiovascular Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Protease and Inhibitor Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Signaling Pathways in Disease
- Keywords
- cardiac remodeling, heart failure, extracellular matrix remodeling, matrix metalloproteinases, tissue inhibitors of metalloproteinases, TIMP-3, ADAMS, myocardial fibrosis
- MeSH terms
- Animals, Disease Models, Animal, Extracellular Matrix, Heart Failure, Humans, Tissue Inhibitor of Metalloproteinases, Ventricular Remodeling, Matrix Metalloproteinases
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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