{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:17:40Z","timestamp":1790291860713,"version":"4.1.0"},"reference-count":132,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Oxidative stress contributes to heart failure (HF) progression by mechanisms that go beyond hemodynamic overload, including mitochondrial dysfunction, endothelial injury, inflammation, and fibrotic remodeling. This review evaluates the relationship between redox imbalance, Galectin-3 (Gal-3), fibrosis, and imaging findings in HF. Reactive oxygen species (ROS) generated by mitochondria, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, and xanthine oxidase may disturb calcium handling, impair mitochondrial function, activate fibroblasts, and promote ferroptosis. Biomarkers of oxidative injury and antioxidant reserve, including malondialdehyde (MDA), 8-hydroxy-2\u2032-deoxyguanosine (8-OHdG), and circulating thiols, provide information complementary to natriuretic peptides. Experimental evidence supports a context-dependent role of Gal-3 in fibro-inflammatory remodeling, whereas circulating Gal-3 should be regarded as a complementary biomarker rather than as a direct measure of myocardial fibrosis. Echocardiography assesses functional remodeling through diastolic indices, myocardial deformation, and right ventricular\u2013pulmonary arterial (RV\u2013PA) coupling, while cardiac magnetic resonance characterizes focal scar and diffuse interstitial remodeling using late gadolinium enhancement, native T1 mapping, and extracellular volume fraction. Therapeutic strategies are increasingly shifting from nonspecific antioxidant supplementation toward targeting ROS sources and downstream pathways, with SGLT2 inhibitors emerging as clinically relevant agents with indirect redox-modulating effects. Integrated redox, fibro-inflammatory, hemodynamic, and imaging phenotyping may refine risk stratification, although prospective validation is required before routine implementation.<\/jats:p>","DOI":"10.3390\/antiox15080919","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:36:13Z","timestamp":1784878573000},"page":"919","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["From Oxidative Stress to Fibrotic Remodeling: Integrating Redox Biology, Galectin-3, and Imaging Phenotypes in Heart Failure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8194-4501","authenticated-orcid":false,"given":"Samuel","family":"Ardelean","sequence":"first","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"},{"name":"Department V\u2014Internal Medicine 1, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Multidisciplinary Heart Research Center, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrada","family":"Ardelean","sequence":"additional","affiliation":[{"name":"Department of Rheumatology- Physical Medicine and Rehabilitation Clinic- Municipal Emergency Clinical Hospital, 300020 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana-Evelyne","family":"Buzzi","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1336-8465","authenticated-orcid":false,"given":"Andrei-Catalin","family":"Zavragiu","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Rus","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena-Larisa","family":"Zimbru","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Department of Cardiology, Institute of Cardiovascular Diseases, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"},{"name":"Center of Immuno-Physiology and Biotechnologies, Department of Functional Sciences, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"},{"name":"Center for Gene and Cellular Therapies in the Treatment of Cancer\u2014OncoGen, Timi\u0219 County Emergency Clinical Hospital \u201cPius Br\u00eenzeu\u201d, 300723 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad Ioan","family":"Morariu","sequence":"additional","affiliation":[{"name":"Department V\u2014Internal Medicine 1, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Multidisciplinary Heart Research Center, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-5404","authenticated-orcid":false,"given":"Ruxandra Maria","family":"Christodorescu","sequence":"additional","affiliation":[{"name":"Department V\u2014Internal Medicine 1, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Research Center, Institute of Cardiovascular Diseases Timi\u0219oara, Gheorghe Adam St., No. 13A, 300310 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Sturza","sequence":"additional","affiliation":[{"name":"Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, \u201cVictor Babes\u0326\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minodora","family":"Andor","sequence":"additional","affiliation":[{"name":"Department V\u2014Internal Medicine 1, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"},{"name":"Multidisciplinary Heart Research Center, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alcidi, G., Goffredo, G., Correale, M., Brunetti, N.D., and Iacoviello, M. 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