REVIEW article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Advances in Targeting Myocardial Fibrosis: Integrating Mechanisms and Therapeutics
Zihui Xu
Yuyan Zhao
The First Affiliated Hospital of China Medical University, Shenyang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract
Myocardial fibrosis (MF) is a maladaptive pathological response of the heart to chronic injury. Accumulating evidence indicates that MF plays a central role in the development and progression of hypertensive heart disease, ischemic cardiomyopathy, diabetic cardiomyopathy, and heart failure, and is closely associated with an increased risk of arrhythmias and sudden cardiac death. In recent years, advances in experimental and analytical approaches have improved our understanding of the molecular mechanisms underlying MF and informed the development of potential therapeutic strategies. However, many existing pharmacological interventions exhibit limited target specificity, uncertain long-term efficacy, and incompletely defined mechanisms of action in humans. In this review, we summarize the major molecular pathways involved in myocardial fibrosis and discuss current and emerging therapeutic approaches, incorporating mechanistic insights from recent single-cell and spatial transcriptomic studies to better contextualize fibrotic signaling heterogeneity and translational challenges.
Summary
Keywords
Drug Development, Fibroblast activation, Heart Failure, Myocardial fibrosis, therapeutic targets
Received
16 December 2025
Accepted
13 February 2026
Copyright
© 2026 Xu and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yuyan Zhao
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.