Cardiomyopathies encompass a spectrum of heart disorders with diverse causes and presentations. Fibrosis stands out as a shared hallmark among various cardiomyopathies, reflecting a common thread in their pathogenesis. This prevalent fibrotic response is intricately linked to the consequences of dysregulated extracellular matrix (ECM) remodeling, emphasizing its significance in the development and progression the disease. This review explores the ECM involvement in various cardiomyopathies and its impact on myocardial stiffness and fibrosis. Additionally, we discuss the potential of ECM fragments as early diagnosis, prognosis, and risk stratification. Biomarkers deriving from turnover of collagens and other ECM proteins hold promise in clinical applications. We outline current clinical management, future directions, and the potential for personalized ECM-targeted therapies with specific focus on microRNAs. In summary, this review examines the role of the fibrosis in cardiomyopathies, highlighting the potential of ECM-derived biomarkers in improving disease management with implications for precision medicine.

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纤维化在心肌病中的作用：开发疾病活动新生物标志物的机会

心肌病包括一系列具有不同原因和表现的心脏病。纤维化是各种心肌病的共同标志，反映了其发病机制的共同点。这种普遍的纤维化反应与细胞外基质（ECM）重塑失调的后果密切相关，强调了其在疾病发生和进展中的重要性。本综述探讨了 ECM 参与各种心肌病及其对心肌僵硬度和纤维化的影响。此外，我们还讨论了 ECM 片段作为早期诊断、预后和风险分层的潜力。源自胶原蛋白和其他 ECM 蛋白更新的生物标志物在临床应用中具有广阔的前景。我们概述了当前的临床管理、未来的方向以及个性化 ECM 靶向治疗的潜力，特别关注 microRNA。总之，本综述探讨了纤维化在心肌病中的作用，强调了 ECM 衍生的生物标志物在改善疾病管理方面的潜力，并对精准医疗产生影响。