Myocardial fibrosis: A chronic inflammatory process / 中国组织工程研究

ABSTRACT

OBJECTIVE:The pathophysiology of myocardial fibrosis during hypertension is complicated.Recently,it has been shown that inflammatory response plays an important role in the pathophysiology of myocardial fibrosis.This review describes the relationships among hemodynamic stress,hormonal factors and inflammatory factors,and emphasizes the important position of inflammation during the progress of myocardial fibrosis.DATA SOURCESUsing the terms of "hypertension,myocardial fibrosis,inflammatory response,angiotensin,cytokines" in English and Chinese respectively,we searched Medline database,Chinese Biological Medicine Database (CBM) and CNKI to identify English and Chinese articles of clinical researches and experiments related to the effects of inflammatory response on myocardial fibrosis during hypertension published from January 1991 to May 2007.STUDY SELECTIONThe articles were primarily checked.Only articles that reported inflammatory response and myocardial fibrosis were included.The repeated researches and experiments and Meta analysis were deleted.DATA EXTRACTIONA total of 641 articles have been selected.The titles of all the articles and most of the abstracts have been read,and 162 articles met the inclusive criteria whereas the other 479 articles were deleted.42 articles have been analyzed.DATA SYNTHESIS:During hypertension,the extracellular matrix expands because of reactive and reparative fibrosis,which at last results in myocardial fibrosis.Previous clinical and experimental studies showed that hemodynamic stress and hormonal factors affected the progress of myocardial fibrosis.While recently,there are growing evidences indicating that the immune system.related with hemodynamic stress and hormonal factors is activated during hypertension in the progress of myocardial fibrosis.Then the recruitment of inflammatory cells and factors,including chemoattractant proteins,adhesion molecules and cytokines,informing cytokines cascade response,in turn accelerate the progress of myocardial fibrosis.CONCLUSION:Inflammatory response may play an important role in the pathophysiology of myocardial fibrosis during hypertension and then accelerate the progress of heart failure.