Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 65, Issue 22, Pages 2449-2456Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2015.04.026
Keywords
biomarker; collagen; endomyocardial biopsy; fibrosis; heart failure
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Funding
- Ministry of Economy and Competitiveness, Spain (Instituto de Salud Carlos III grant) [RD12/0042/0009]
- European Commission [FP7-HEALTH-2010-261409, FP7-HEALTH-2011-278249, FP7-HEALTH-2012-305507, FP7-HEALTH-2013-602904]
- Ramon y Cajal contract from the Ministry of Economy and Competitiveness, Spain [RYC-2010-05797]
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Myocardial fibrosis impairs cardiac function, in addition to facilitating arrhythmias and ischemia, and thus influences the evolution and outcome of cardiac diseases. Its assessment is therefore clinically relevant. Although tissue biopsy is the gold standard for the diagnosis of myocardial fibrosis, a number of circulating biomarkers have been proposed for the noninvasive assessment of this lesion. A review of the published clinical data available on these biomarkers shows that most of them lack proof that they actually reflect the myocardial accumulation of fibrous tissue. In this call to action article, we propose that this absence of proof may lead to misinterpretations when considering the incremental value provided by the biomarkers with respect to traditional diagnostic tools in the clinical handling of patients. We thus argue that strategies are needed to more strictly validate whether a given circulating biomarker actually reflects histologically proven myocardial fibrosis before it is applied clinically. (C) 2015 by the American College of Cardiology Foundation.
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