Role of Imaging and Biomarkers in Identifying, Monitoring, and Promoting Myocardial Recovery

Figures

• 

  Figure 1. Late gadolinium enhancement on cardiac magnetic resonance. Late gadolinium enhancement (LGE) cardiac magnetic resonance image obtained in a patient with ischemic cardiomyopathy. Severe reduced left ventricular ejection fraction (LVEF 17%) with approximately 40% LGE in the left ventricle. Despite optimal medical therapy, no myocardial recovery was expected. Four years later, due to recurrent sustained ventricular tachycardia, the patient was referred for left ventricular assist device.

• 

  Figure 2. Different biomarkers according to their pathophysiological action.

• 

  Figure 3. sST2 and galectin-3 as markers of fibrosis. As a response to cardiac damage, macrophage activation results in the production of galectin-3, which leads to fibroblast activation and the release of IL-33. Normally, IL-33 binds to ST2L, by which it initiates an antihypertrophic an antifibrotic pathway. sST2 works as a decoy receptor, preventing the binding of IL-33 to ST2L. IL-33: interleukin-33; sST2: soluble suppression of tumorigenicity 2; ST2L: suppression of tumorigenicity 2 ligand