Consecuencias clínicas de la fibrosis miocárdica en la cardiopatía hipertensiva

Changes in the composition of cardiac tissue develop in arterial hypertension and lead to structural remodeling of the myocardium. Structural remodeling is the consequence of a number of pathologic processes, mediated by mechanical, neurohormonal and cytokines factors that occur in the cardiomyocyte and the non-cardiomyocyte compartments of the heart. One of these processes is related to the disruption of the equilibrium between the synthesis and degradation of collagen type I and III molecules. This causes an excessive accumulation of collagen type I and III fibers in the interstitium and the perivascular regions of the myocardium. The clinical relevance of myocardial fibrosis is that it might contribute to increased cardiac risk of patients with hypertensive heart disease. This revision focuses on the clinical consequences of hypertensive myocardial fibrosis. In addition, non-invasive methods for the diagnosis of cardiac fibrosis and the therapeutic strategies aimed at promoting its reduction will be also considered.