Javier Díez, Rudolf A de Boer, Management of cardiac fibrosis is the largest unmet medical need in heart failure, Cardiovascular Research, 2021;, cvab228, https://doi.org/10.1093/cvr/cvab228
A diffuse accumulation of collagen fibres within the myocardial interstitium occurs in nearly all chronic cardiac diseases. Because cardiac fibrosis is a key contributor to heart failure (HF) and its progression, it has important prognostic implications both in ischaemic heart disease and non-ischaemic cardiac diseases. In this regard, cardiac fibrosis is a major driver associated with the growing burden of HF, especially in older people. However, integrating cardiac fibrosis in HF management is still an unmet medical need, which may be explained by its high tissue heterogeneity and clinical diversity, and, as a consequence, the very real limitations of its diagnosis and treatment. In this viewpoint paper, we summarize the challenges and requirements in the clinical management of cardiac fibrosis in HF patients.