心肌梗死后心肌纤维化的研究进展

心肌纤维化是心肌梗死后主要的病理过程，特征是细胞外基质合成和降解失衡，而成纤维细胞和肌纤维母细胞在此过程中起重要作用。心肌梗死后，梗死区域替代性纤维化可以减少梗死区域进一步的扩张，维持心室结构完整性，防止心室壁破裂；而非梗死区域的反应性纤维化，则会改变心室顺应性，增加心室壁的硬度，影响心脏的收缩和舒张功能。因此，心肌梗死后理想的治疗是抑制非梗死区域反应性纤维化、诱导梗死区域心肌再生，从而改善心功能。

Progress in research of myocardial fibrosis after myocardial infarction

Myocardial fibrosis is the main pathological process during the post-myocardial infarction phase (post-MI), which is characterized by the imbalance between extracellular matrix (ECM) synthesis and degradation, in which fibroblasts and myofibroblasts play an important role. Replacement fibrosis can reduce the further expansion of the infarction area, maintain ventricular integrity, and prevent ventricular wall rupture after MI. However, reactive fibrosis in the infarct border zone and in the remote uninjured myocardium leads to altered chamber compliance and increased ventricular stiffness, thereby compromising cardiac output. Therefore, an ideal therapy for MI-induced cardiac injury would combine the inhibition of reactive fibrosis (and other remodeling processes) in non-infarct areas with the induction of the regeneration of the infarcted myocardium to improve heart function.