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Biomarkers in Cardiovascular Disease pp 1–34Cite as

Disease Focused Approach on Fibrosis Biomarkers in Cardiovascular Health

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Abstract

Cardiac fibrosis is a marker of pathological remodeling and a risk factor for multiple conditions, in particular heart failure and cardiac arrhythmias. Although methods for detection of large-scale cardiac fibrosis are being developed using imaging modalities, these methods are limited in terms of both sensitivity for detection of low-level fibrosis and specificity for different pathways leading to fibrosis. A number of circulating biomarkers of mediators of the fibrosis process can be measured in the plasma, and the goal is that these markers might provide early detection of cardiac fibrosis or direct therapies toward specific pathological conditions. However, while several circulating fibrosis biomarkers hold promise based on clinical investigations, more studies are needed before these factors are ready for application to clinical decision making.

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Abbreviations

AF:

Atrial fibrillation

BMP-1:

Bone morphogenetic protein-1

BNP (NT-proBNP):

Brain natriuretic peptide (N-terminal pro-brain natriuretic peptide)

CITP:

C-terminal telopeptide, type I collagen

CTGF:

Connective tissue growth factor

ECG:

Electrocardiogram

ECM:

Extracellular matrix

FN:

Fibronectin

Gal-3:

Galectin-3

HCM:

Hypertrophic cardiomyopathy

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction (diastolic heart failure)

HFrEF:

Heart failure with reduced ejection fraction (systolic heart failure)

ICD:

Implantable cardioverter defibrillator

IL-(10,18,33):

Interleukin-(10,18,33)

LA:

Left atrial

LGE:

Late gadolinium enhancement

LV:

Left ventricle

miRNA/mRNA:

Micro-ribonucleic acid/messenger ribonucleic acid

MMP (1–13):

Matrix metalloproteinase (types 1–13)

MRI:

Magnetic resonance imaging

NITP:

N-terminal telopeptide, type I collagen

OPN:

Osteopontin

PICP:

Procollagen C-terminal peptide, type I collagen

PIIINP:

Procollagen N-terminal peptide, type III collagen

PINP:

Procollagen N-terminal peptide, type I collagen

RAAS:

Renin-angiotensin-aldosterone system

SCD:

Sudden cardiac death

SPARC:

Osteonectin or “secreted protein acidic and rich in cysteine”

sST2:

Soluble ST2

TGF-β:

Transforming growth factor-beta

TIMP (1–4):

Tissue inhibitor of metalloproteinase (types 1–4)

TSP:

Thrombospondin

VT/VF:

Ventricular tachycardia/fibrillation

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Authors and Affiliations

  1. Division of Cardiac Electrophysiology, VA Boston Healthcare System, Harvard Medical School, 1400 VFW Parkway, 111CA, West Roxbury, Boston, MA, 02132, USA

    Michael A. Rosenberg

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  1. Michael A. Rosenberg
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Correspondence to Michael A. Rosenberg .

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Editors and Affiliations

  1. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Sciences Division, King's College, London, United Kingdom

    Victor R. Preedy

Definitions

Arrhythmia

Abnormal electrical activity in the heart; generally categorized into problems with slow or impaired conduction (bradyarrhythmias) or problems with rapid or disorganized conduction (tachyarrhythmias). Tachyarrhythmias include “tachycardias,” where electrical activity is organized, and “fibrillation,” where electrical activity is disorganized.

Atrial fibrillation

A cardiac condition in which the electrical activity in the atria is disorganized, causing the appearance of fibrillation on electrocardiogram (ECG).

Cardiac fibrosis

Deposition of collagen in the heart, typically associated with pathological cardiac conditions.

Collagen

A polypeptide formed from three alpha helices that makes up much of the connective tissue of the body. There have been 28 types described, although type 1 (fibrillar collagen) is most abundant.

Diastolic heart failure

Also known as “heart failure with preserved ejection fraction,” which refers to heart failure symptoms occurring when the ejection fraction of the heart is >50 %.

Late gadolinium enhancement

A finding from contrast cardiac magnetic resonance imaging in which gadolinium is “held up” within the walls of the heart, typically used to identify areas of fibrosis.

Myocardial infarction

A condition of acute myocardial cell death, typically resulting from obstruction to the coronary artery system, which if untreated can result in scar formation in the heart.

Pressure overload model

Animal model in which the outflow from the left ventricle is partially constricted, leading to hypertrophy of the heart muscle; designed to mimic high blood pressure or aortic stenosis leading to diastolic heart failure.

Reactive fibrosis

Fibrosis that occurs around living cells, typically due to activation of inflammatory pathways.

Replacement fibrosis

Fibrosis that occurs in the setting of cell death, in which the “scar” formed replaces the previously living cells to maintain organ structure.

Sudden cardiac death

By definition, refers to any sudden death in an individual previously observed to be healthy a brief period beforehand; generally, used to refer to death or near death due to lethal ventricular arrhythmias, ventricular fibrillation, or ventricular tachycardia.

Systolic heart failure

Also called “heart failure with reduced ejection fraction”; refers to the cardiac condition in which the normal pump function (ejection fraction) becomes depressed.

Volume overload model

Animal model in which excess blood is returned to the heart, causing it to dilate; designed to mimic systolic heart failure.

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Rosenberg, M. (2016). Disease Focused Approach on Fibrosis Biomarkers in Cardiovascular Health. In: Patel, V., Preedy, V. (eds) Biomarkers in Cardiovascular Disease. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7741-5_48-2

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  • DOI: https://doi.org/10.1007/978-94-007-7741-5_48-2

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  • Online ISBN: 978-94-007-7741-5

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  1. Latest

    Disease Focused Approach on Fibrosis Biomarkers in Cardiovascular Health
    Published:
    13 April 2016

    DOI: https://doi.org/10.1007/978-94-007-7741-5_48-2

  2. Original

    Circulating Fibrosis Biomarkers and Cardiovascular Health: Disease-Focused Approach in Heart Failure, Arrhythmias, Sudden Cardiac Death, and Atrial Fibrillation
    Published:
    04 February 2016

    DOI: https://doi.org/10.1007/978-94-007-7741-5_48-1

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