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More than just a small left ventricle: the right ventricular fibroblast and ECM in health and disease


Abstract Fibroblasts intricately organize and regulate the extracellular matrix (ECM) in cardiac health and disease. Excess deposition of ECM proteins causes fibrosis, resulting in disrupted signaling conduction and contributing to the development of arrhythmias and impaired cardiac function. Fibrosis is causally involved in cardiac failure in the left ventricle (LV). Fibrosis likely occurs in right ventricle (RV) failure, yet mechanisms remain unclear. Indeed, RV fibrosis is poorly understood with mechanisms often extrapolated from the LV to the RV. However, emerging data suggest that the LV and RV are distinct cardiac chambers and differ in regulation of the ECM and response to fibrotic stimuli. In the present review, we will discuss differences in ECM regulation in the healthy RV and LV. We will discuss the importance of fibrosis in the development of RV disease in pressure overload, inflammation, and aging. During this discussion, we will highlight mechanisms of fibrosis with respect to the synthesis of ECM proteins while acknowledging the importance of considering collagen breakdown. We will also discuss current knowledge of antifibrotic therapies in the RV and the need for additional research to help delineate the shared and distinct mechanisms of RV and LV fibrosis.
Authors Benjamin D. McNair University of Wyoming , Samantha K. Shorthill University of Wyoming , Danielle R. Bruns University of WyomingORCID
Journal Info American Physical Society | American Journal of Physiology: Heart and Circulatory Physiology , vol: 325 , iss: 2 , pages: H385 - H397
Publication Date 8/1/2023
ISSN 0363-6135
TypeKeyword Image article
Open Access closed Closed Access
DOI https://doi.org/10.1152/ajpheart.00213.2023
KeywordsKeyword Image Electrocardiogram Interpretation (Score: 0.520003) , Arrhythmogenic Right Ventricular Cardiomyopathy (Score: 0.516771) , Fibrosis (Score: 0.516401) , Extracellular Matrix (Score: 0.504255)